To assess the impact and cost‐effectiveness of two information‐based provider reminder interventions designed to improve self‐care management and outcomes of heart failure (HF) patients.
Interview and agency administrative data on 628 home care patients with a primary diagnosis of HF.
Patients were treated by nurses randomly assigned to usual care or one of two intervention groups. The intervention was an e‐mail to the patient's nurse highlighting six HF‐specific clinical recommendations. The intervention supplemented the initial nurse reminder with additional clinician and patient resources.
Patient interviews were conducted 45 days post admission to measure self‐management behaviors, HF‐specific outcomes (Kansas City Cardiomyopathy Questionnaire‐KCCQ), health‐related quality of life (EuroQoL), and service use.
Both interventions improved the mean KCCQ summary score (15.3 and 12.9 percent, respectively) relative to usual care (≤.05). The basic intervention also yielded a higher EuroQoL score relative to usual care (≤.05). In addition, the interventions had a positive impact on medication knowledge, diet, and weight monitoring. The basic intervention was more cost‐effective than the augmented intervention in improving clinical outcomes.
This study demonstrates the positive impact of targeting evidence‐based computer reminders to home health nurses to improve patient self‐care behaviors, knowledge, and clinical outcomes. It also advances the field's limited understanding of the cost‐effectiveness of selected strategies for translating research into practice.
Data Sources/Study Setting