Main Findings : The results indicate that an intervention involving any human factor principles may nearly double an individual ’s probability of not being readmitted .
Principal Conclusions : Interventions with human factor principles reduce readmissions among HF patients .
Background : Human factors play an important role in health-care outcomes of heart failure ( HF ) patients .
A systematic review and meta- analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies .
Purpose : To investigate how the 8 guiding principles of choice , rest , environment , activity , trust , interpersonal relationships , outlook , and nutrition reduce HF readmissions .
Uptake of self-management strategies in a heart failure management programme.
BACKGROUND Multidisciplinary heart failure programs including patient education and self-management strategies such as daily recording of body weight and use of a patient diary decrease hospital readmissions and improve quality of life . However , the degree of uptake of individual components of these programs and their contribution to patient benefit are uncertain . METHODS Patients with heart failure admitted to Auckl and Hospital were r and omised into the management or usual care groups of the Auckl and heart failure management study ( AHFMS ) . Patients in the management group were given a heart failure diary for the recording of daily weights , attended a heart failure clinic and were encouraged to attend three education sessions . Patients in the usual care group received routine clinical care , mainly from general practitioners . Patients were followed to 12 months . This study investigated the uptake of self-management by assessing diary use and self-weighing behaviour in the group receiving the heart failure intervention , and compared the level of knowledge of heart failure self-management of the management group to the control group after 12 months . RESULTS Of the 197 patients in the AHFMS , 100 patients were included in the management group  and received a diary and education about heart failure self-management including  monitoring weight daily .  Of these patients , 76 patients used the diary  . These patients were on more medication ; were more likely to attend the education sessions , heart failure clinic , and primary care , and had a lower mortality rate over the course of the study . Variables independently associated with use of the diary included less severe symptoms ( OR 15 , 95 % confidence intervals 1.7 , 144 ) , frequent attendance at the heart failure clinic ( OR 15 , 95 % CI 3 , 78 ) and attendance at an education session ( OR 8 , 95 % CI 1.5 , 42 ) . Of the 76 patients who used the diary , 51 weighed themselves regularly . More of these patients owned scales at home ; they were also more likely to attend the education sessions , and experienced fewer hospital admissions than those patients who did not weigh themselves regularly . Variables independently associated with regular self-weighing included the presence of scales at home ( OR 6.3 , 95 % CI 1.7 , 14.1 ) , left ventricular ejection fraction > 30 % ( OR 4.3 , 95 % CI 1.1 , 17.5 ) , and attendance at the education session(s ) ( OR 6.3 , 95 % CI 1.7 , 14.1 ) . Patients in the management group exhibited higher levels of knowledge at 12 months of follow-up and were more likely to monitor their condition using daily weighing , compared to the control group . CONCLUSIONS At 12 months of follow-up , implementation of self-management strategies including daily weight monitoring and level of education on self-management was significantly higher in the management group than the control group . For the patients in the management group , not using the diary or inability to perform daily weighing were associated with less frequent attendance at the heart failure clinic and education sessions and poorer health outcomes . In this study , attendance at the education sessions was associated with the adoption of self-management , underlining the importance of education in multidisciplinary heart failure programmes . Self-weighing could be increased by provision of scales to all patients . The subset of patients who did not adopt self-management strategies in this study were at high risk of death or readmission
Main Findings : The results indicate that an intervention involving any human factor principles may nearly double an individual ’s probability of not being readmitted .
Principal Conclusions : Interventions with human factor principles reduce readmissions among HF patients .
Background : Human factors play an important role in health-care outcomes of heart failure ( HF ) patients .
A systematic review and meta- analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies .
Purpose : To investigate how the 8 guiding principles of choice , rest , environment , activity , trust , interpersonal relationships , outlook , and nutrition reduce HF readmissions .