Purpose: Self-management is highly heterogenous in quality of life in individuals with chronic heart failure. The distributions, the extents of self-management strategies and changes over time of these may play a role in this uncertainty. The aim of this study was to identify clinically meaningful strategies that improve quality of life reflected by patient-reported outcomes in those with chronic heart failure.
Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from May 2017 to May 2019. Self-management advice was provided in written form at discharge to all patients. Information regarding chronic heart failure in patient-reported outcomes and self-management were collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of self-management strategies for patient-reported outcome of chronic heart failure (CHF-PRO) scores, as well as its physical and psychological domains. Minimal clinically important difference was introduced to further evaluate clinical significance.
Results: Scores for CHF-PRO improved significantly after discharge. A regular schedule, avoidance of over-eating, and a low-sodium diet increased scores on patient-reported outcomes, including overall scores and physical and psychological scores. In addition, exercise improved patient-reported outcomes and its physical domain. The use of angiotensin-converting enzyme inhibitors also increased physical scores. Among these variables, a regular daily schedule and avoidance of over-eating almost every day reached clinical significance for CHF-PRO scores, as well as its physical and psychological domains.
Conclusions: Self-management, especially the avoidance of over-eating and maintenance of a regular schedule will improve patient-reported outcomes in those with chronic heart failure.
Trial registration: 2018LL128, January 2, 2018.