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US Study Shows Counseling May Not Help Heart-Failure Patients


A heart patient's vital stats are checked by one of the medical staff

A heart patient's vital stats are checked by one of the medical staff

People with heart failure often need to make major changes in their lives in order to live longer, including controlling their weight and exercising regularly. Few patients, however, are able to do this. As a result, many have repeated hospitalizations and early deaths. That's what a new study shows from researchers in Chicago, who originally thought better patient education might result in better health management.

In the United States, heart failure is the fastest growing cause of hospitalization. Many people in other countries also suffer from the disease. World Health Organization statistics show that at least 17 million people around the world die of cardiovascular disease each year, including those who have heart failure.

Put simply, heart failure means the heart can't pump enough blood to meet the body's needs. With time, the heart weakens until it can no longer pump.

Katie Coffee suffers from heart failure and tries to follow her doctor's orders. "I feel better. And I've been walking a lot. So the more I walk, the better I feel."

Doctors say teaching heart-failure patients to take part in self-care is key to successfully treating the disease. This "self-care" involves taking medicines on time, limiting salt in food, reducing or eliminating alcoholic beverages, regular exercise, maintaining a healthy weight, and if they smoke, stopping.

Research shows, though, that 50 percent to 80 percent of heart failure patients don't change their lifestyles. Another 30 to 60 percent don't consistently take their medications. Health professionals say the reason for such a high failure rate is that patients feel overwhelmed by the number and difficulty of these demands.

Doctor James Calvin, Jr. at Rush University Medical Center in Chicago, Ill., and other researchers wanted to see if they could help these patients. "We were looking to see whether or not we could change patient's behavior through education, as well as helping them learn self-management techniques."

Some patients with heart failure received reading materials from the American Heart Association. Others got counseling in addition to the reading material.

"Forty-seven percent of the patients were women, 40 percent were minorities, so we feel that we put together a population of patients that's representative of the heart failure population of the United States," said Calvin.

Over the course of the study, the doctors did not see much difference between the two groups. In both groups, about 40 percent of patients were either hospitalized or died. While the results were disappointing, the researchers saw that some patients did benefit.

Professor Lynda Powell is one of the researchers. She chairs the department of preventive medicine at Rush University Medical Center and she noted, "Self-management counseling actually had a benefit for the low-income patients and education actually had a benefit for the high-income patients."

Professor Powell said the study shows paying more attention to the special needs of different patient groups can have an impact. The researchers now want to study the effect of tailoring treatment based on the patients' income.

The report was published in the Journal of the American Medical Association.

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