Differences in Education, Knowledge, Self-Management Activities, and Health Outcomes for Patients with Heart Failure Cared for Under the Chronic Disease Model

This article reports educational, interpersonal and health outcomes for patients with heart failure treated by provider teams who had participated in a series of quality improvement collaborative meetings designed to foster major changes in heart failure care based on the Chronic Care Model. The model encourages productive interactions between proactive provider teams and well-informed and motivated patients. The seven participating sites included outpatient clinics at mid-sized hospitals; a large urban public hospital; a nonprofit health plan; small urban physician practices and a large, urban private hospital. Each site included a participant and control pair. Researchers interviewed a total of 781 patients by telephone 10 months, on average, after the start of the intervention.

Key Findings:

  • Among patients in the participant group, 86.5 percent reported that they were told to weigh themselves daily in contrast to 34.0 percent in the control group.
  • Patients in the participant group were more knowledgeable about their disease than were control patients. They were twice as likely to say that someone with heart failure should check his/her weight several times weekly and had greater knowledge of high-salt foods and of symptoms of worsening heart failure.
  • In comparison to the control group, patients in the participant group reported better communication with their doctors and nurses with regard to treatment options, confidence in their ability to make lifestyle changes and review of their management of their condition.
  • Participant patients had fewer emergency room visits and hospitalizations than control patients, but a similar health-related quality of life.