The Heart Failure Adherence and Retention Trial (HART): design and rationale.

摘要: Background Heart failure (HF) is increasing in prevalence and associated with prolonged morbidity, repeat hospitalizations, high costs. Drug therapies lifestyle changes can reduce but nonadherence high, ranging from 30% to 80%. There an urgent need identify cost-effective ways improve adherence hospitalizations. Trial Design The Failure Adherence Retention (HART) evaluated the benefit of patient self-management (SM) skills training combination HF education, over education alone, on composite end points death/HF hospitalizations death/all-cause patients mild moderate systolic or diastolic dysfunction. Secondary included progression HF, quality life, drug regimens, psychosocial function. HART cohort was composed 902 including 47% women, 40% minorities, 23% After a baseline examination, were randomized SM control, received 18 treatment contacts 1 year, annual follow-ups, 3-month phone calls assess primary points. Self-management conducted small groups aimed activate implement through problem-solving 5 skills. control mail followed by call check comprehension. Conclusions significance lies its ability determine clinical value activating collaborate his her care. Support for trial hypotheses would encourage interdisciplinary treatment, drawing evidence base not only medicine also behavioral medicine.