Key result
Individual peer support significantly improved heart failure self-care at 3 months (P < .05), but the heart failure readmission rate was 96% higher compared to the control group.
Why the study?
Does individual peer support improve self-care and clinical outcomes in hospitalized patients with chronic heart failure?
RCT
randomized
Does individual peer support improve self-care and clinical outcomes in hospitalized patients with chronic heart failure?
p-value: p=< .05
Individual peer support for heart failure patients improved self-care but did not improve clinical outcomes like readmissions or cost, and was associated with low patient enrollment.
Caution against peer support in heart failure; challenges translation of self-care gains into reduced readmissions.
Peer support has been used effectively in a variety of patient populations, but its effectiveness in improving outcomes in persons with chronic heart failure has not been explored. We trained 9 persons with heart failure to mentor other heart failure patients and tested the effectiveness of this approach in a randomized controlled clinical trial. A low proportion (37%) of the eligible population of hospitalized patients agreed to participate. At the end of the 3-month trial, there was significantly higher heart failure self-care in the intervention group (P < .05). The only difference in social support was a significant decline in perceived support reciprocity in the intervention group (F = 5.94, P = .004). No significant group differences in heart failure readmissions, length of stay, or cost were evident at 90-days, although the heart failure readmission rate was 96% higher in the intervention group when compared to that in the control group. The reasons for low overall enrollment and high readmission rates in the intervention group require further study. Including additional self-care education by a professional, rather than leaving all the education to the mentor, could strengthen the peer support intervention trialed in this study. Small group meetings may be less intrusive and more desirable for this patient population.
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Riegel et al. (2004) conducted an RCT in chronic heart failure. Individual peer support vs. Control group was evaluated on Heart failure self-care (p=< .05). Individual peer support significantly improved heart failure self-care at 3 months (P < .05), but the heart failure readmission rate was 96% higher compared to the control group.