A randomized controlled trial to assess the effectiveness of structured discharge counseling on heart failure outcomes

Introduction: A relatively common disease, heart failure (HF), has a significant impact on the quality of life (QOL). Many of the HF patients are unaware of the importance of self-care, such as weighing themselves regularly, fluid and sodium restriction, and HF symptom monitoring. Important patient-related factors that are known to be related to compliance are HF knowledge and its regimen. The Objectives of the Study: The objective of this study is to assess the effectiveness of structured discharge counseling on HF knowledge, QOL, frequency of repeated hospitalization, and improvement in the New York Heart Association (NYHA) functional class of acute decompensated HF (ADHF) patients. Materials and Methods: Sixty-eight ADHF patients (NYHA functional Class III) were selected and randomized into two groups. HF knowledge and QOL were measured for each patient. A 30-min discharge counseling was provided at hospital visit or at the time of discharge. Both the groups were followed for 1 month. Data on HF knowledge, QOL, NYHA functional class, and repeated hospitalization were collected at baseline and after 1 month. Results: The baseline HF knowledge and QOL were comparable in both the groups. The experimental group showed significant improvement in QOL scores (P = 0.001), HF knowledge score (P = 0.043), and NYHA functional class (P = 0.001) after 1 month of the discharge counseling. Conclusion: The present study showed that the discharge counseling could enhance HF knowledge, QOL, and NYHA functional class in those suffering from ADHF. It is, therefore, advisable that discharge counseling be incorporated in the HF management strategy.