Can We Improve Quality of Life in Heart Failure - Results of the National Educational Study

Background: Heart Failure (HF) is serious, negatively modulating not only patients' activities but also quality of life (QOL). In general this population is characterized by low QOL. It is documented that some of the costly disease management programs improve it. It is unknown if simple educational intervention improves QOL in HF pts. Objectives: The aim of this study was to assess if teaching session with handed over educational materials may influence QOL. Methods: It was multicenter national study assessing HF subjects from general practitioners" practices. Population. 617 pts. with HF from 9 districts in Poland randomized to: educational group (E) n=270 and control group (C) n= 347. E group took part in a single educational session. During the session pts. received information about theoretical and practical aspects of HF management. Pts. received HF brochures and weight monitoring training. C group stayed under regular care from GP. A WHO-bref questionnaire was used for QOL assessment (including 4 domains). QOL was reevaluated after 6 months. Results: There were 57% vs. 53% of males in E and C, mean age in both groups was 66.9 vs. 69.3 yrs., civil status- married 65% vs. 59% of patients, living alone 11,7% vs. 18.9%, level of education primary or vocational 58% vs. 58%, percentage of pts. on disability pension (among those who should be professionally active) 63% vs. 63%. Clinical status - there were 46% vs. 55% of pts. having at least 3 comorbidities (3COM) and most of subjects were in NYHA classes I/II 74% vs. 69%. Pharmacotherapy: ACEI 89% vs. 88%. BB 76% vs. 77%. QOL Table presents results of QOL assessment at the baseline and during follow-up. Both groups had low/v.low QOL which did not change during f-up. PHD, physical domain (max. 35 points); PSD, psychological domain (max. 30); SOD, social domain (max. 15); END, environmental domain (max. 40). p=ns for the difference between the groups with exception for END baseline and follow-up (p=0.01); p=ns for trends over time. Conclusion: HF pts. have very low QOL. Simple educational intervention regarding practical approach to Hf management did not results in QOL improvement.