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Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure
AIMS: In addition to giving optimal medical and device therapy, promoting self‐care of chronic heart failure (CHF) patients also plays an important role in comprehensive disease management for better outcomes. The study was aimed to investigate whether short message service (SMS) would help to impro...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352960/ https://www.ncbi.nlm.nih.gov/pubmed/30478888 http://dx.doi.org/10.1002/ehf2.12380 |
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author | Chen, Chen Li, Xiao Sun, Lisha Cao, Sha Kang, Yu Hong, Liu Liang, Yaodan You, Guiying Zhang, Qing |
author_facet | Chen, Chen Li, Xiao Sun, Lisha Cao, Sha Kang, Yu Hong, Liu Liang, Yaodan You, Guiying Zhang, Qing |
author_sort | Chen, Chen |
collection | PubMed |
description | AIMS: In addition to giving optimal medical and device therapy, promoting self‐care of chronic heart failure (CHF) patients also plays an important role in comprehensive disease management for better outcomes. The study was aimed to investigate whether short message service (SMS) would help to improve death or readmission‐free survival and self‐care behaviour in CHF patients. METHODS AND RESULTS: This was a randomized controlled trial. Between December 2011 and September 2015, patients admitted with decompensated CHF in a tertiary referral hospital who fulfilled the inclusion criteria were enrolled and randomized to receive SMS, structured telephone support (STS), or usual care after discharge. All patients were followed up to 180 days after discharge by phone call or clinic visit. Primary endpoint was the 180 day composite event, defined as all‐cause mortality or readmission. Secondary endpoints included self‐care behaviour and quality of life. Seven hundred sixty‐seven patients (61 ± 15 years, 56.5% male) were finally randomized to receive SMS (n = 252), STS (n = 255), or usual care (n = 260). Baseline characteristics were similar among the three groups. Five hundred twenty‐five (68.4%) patients were in New York Heart Association Class III or IV, and 472 (61.5%) patients had an ejection fraction of <50%. During a 180 day follow‐up, 76 (9.9%) patients died and 274 (35.7%) patients experienced at least one readmission. In a short‐term follow‐up of 30 days, there was no difference in mortality and the composite endpoint among the three groups (SMS vs. STS vs. usual care: 2.8% vs. 3.1% vs. 3.8% for mortality, P = 0.786; 12.3% vs. 14.5% vs. 15.4% for the composite endpoint, P = 0.588). The 180 day composite event rate was significantly lower in the SMS and STS groups (50.4% vs. 41.3% and 36.5%, both P < 0.05) than in the usual care group, but no difference was observed between the two phone‐based intervention groups (P = 0.268). Although there was no difference between the two groups, better self‐care behaviour was reported in the SMS and STS groups than in the control group (medication compliance, 78.9% vs. 81.4% vs. 69.5%, P = 0.011; water restriction, 70.8% vs. 74.5% vs. 61.5%, P = 0.013). Quality‐of‐life score was similar among the three groups at 180 days (P = 0.526). CONCLUSIONS: In CHF patients, post‐discharge SMS, which appeared as efficient as STS, reduced the 180 day composite event and improved self‐care behaviour. SMS intervention could be integrated into CHF management. |
format | Online Article Text |
id | pubmed-6352960 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-63529602019-02-06 Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure Chen, Chen Li, Xiao Sun, Lisha Cao, Sha Kang, Yu Hong, Liu Liang, Yaodan You, Guiying Zhang, Qing ESC Heart Fail Original Research Articles AIMS: In addition to giving optimal medical and device therapy, promoting self‐care of chronic heart failure (CHF) patients also plays an important role in comprehensive disease management for better outcomes. The study was aimed to investigate whether short message service (SMS) would help to improve death or readmission‐free survival and self‐care behaviour in CHF patients. METHODS AND RESULTS: This was a randomized controlled trial. Between December 2011 and September 2015, patients admitted with decompensated CHF in a tertiary referral hospital who fulfilled the inclusion criteria were enrolled and randomized to receive SMS, structured telephone support (STS), or usual care after discharge. All patients were followed up to 180 days after discharge by phone call or clinic visit. Primary endpoint was the 180 day composite event, defined as all‐cause mortality or readmission. Secondary endpoints included self‐care behaviour and quality of life. Seven hundred sixty‐seven patients (61 ± 15 years, 56.5% male) were finally randomized to receive SMS (n = 252), STS (n = 255), or usual care (n = 260). Baseline characteristics were similar among the three groups. Five hundred twenty‐five (68.4%) patients were in New York Heart Association Class III or IV, and 472 (61.5%) patients had an ejection fraction of <50%. During a 180 day follow‐up, 76 (9.9%) patients died and 274 (35.7%) patients experienced at least one readmission. In a short‐term follow‐up of 30 days, there was no difference in mortality and the composite endpoint among the three groups (SMS vs. STS vs. usual care: 2.8% vs. 3.1% vs. 3.8% for mortality, P = 0.786; 12.3% vs. 14.5% vs. 15.4% for the composite endpoint, P = 0.588). The 180 day composite event rate was significantly lower in the SMS and STS groups (50.4% vs. 41.3% and 36.5%, both P < 0.05) than in the usual care group, but no difference was observed between the two phone‐based intervention groups (P = 0.268). Although there was no difference between the two groups, better self‐care behaviour was reported in the SMS and STS groups than in the control group (medication compliance, 78.9% vs. 81.4% vs. 69.5%, P = 0.011; water restriction, 70.8% vs. 74.5% vs. 61.5%, P = 0.013). Quality‐of‐life score was similar among the three groups at 180 days (P = 0.526). CONCLUSIONS: In CHF patients, post‐discharge SMS, which appeared as efficient as STS, reduced the 180 day composite event and improved self‐care behaviour. SMS intervention could be integrated into CHF management. John Wiley and Sons Inc. 2018-11-27 /pmc/articles/PMC6352960/ /pubmed/30478888 http://dx.doi.org/10.1002/ehf2.12380 Text en © 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Articles Chen, Chen Li, Xiao Sun, Lisha Cao, Sha Kang, Yu Hong, Liu Liang, Yaodan You, Guiying Zhang, Qing Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure |
title | Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure |
title_full | Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure |
title_fullStr | Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure |
title_full_unstemmed | Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure |
title_short | Post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure |
title_sort | post‐discharge short message service improves short‐term clinical outcome and self‐care behaviour in chronic heart failure |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352960/ https://www.ncbi.nlm.nih.gov/pubmed/30478888 http://dx.doi.org/10.1002/ehf2.12380 |
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