Key result
GP-delivered education fails to improve quality of life versus routine care in stable chronic HF.
Why the study?
Does a pragmatic patient education programme delivered by general practitioners improve quality of life in patients with chronic heart failure compared with routine care?
RCT (n=241)
Open-label with blinded statistician
Cluster randomized
Yes
Does a pragmatic patient education programme delivered by general practitioners improve quality of life in patients with chronic heart failure compared with routine care?
Mean Difference: 1.19 (95% CI -5.94–8.32)
Absolute Event Rate: 33.4% vs 27.2%
p-value: p=0.74
A pragmatic patient education program delivered by general practitioners did not significantly improve quality of life in elderly patients with stable chronic heart failure compared to routine care.
GP-led education showed no QoL benefit in elderly stable HF; leaves open whether refined primary care strategies improve outcomes.
BACKGROUND: The Education Thérapeutique des patients Insuffisants Cardiaques (ETIC; Therapeutic Education for Patients with Cardiac Failure) trial aimed to determine whether a pragmatic education intervention in general practice could improve the quality of life of patients with chronic heart failure (CHF) compared with routine care. RESULTS: This cluster randomised controlled clinical trial included 241 patients with CHF attending 54 general practitioners (GPs) in France and involved 19 months of follow-up. The GPs in the Intervention Group were trained during a 2-day interactive workshop to provide a patient education programme. The mean age of the patients was 74 years (±10.5), 62 % were men and their mean left-ventricular ejection fraction was 49.3 % (± 14.3). At the end of the follow-up period, the mean Minnesota Living with Heart Failure Questionnaire scores in the Intervention and Control Groups were 33.4 (± 22.1) versus 27.2 (± 23.3; P = 0.74, intra-cluster coefficient [ICC] = 0.11). At the end of the follow-up period, the 36-Item Short Form Health Survey (mental health and physical health) scores in the Intervention and Control Groups were 58 (± 22.1) versus 58.7 (± 23.9; P = 0.58, ICC = 0.01) and 52.8 (± 23.8) versus 51.6 (± 25.5; P = 0.57, ICC = 0.01), respectively. CONCLUSIONS: Patient education delivered by GPs to elderly patients with stable heart failure in the ETIC programme did not achieve an improvement in their quality of life compared with routine care. Further research on improving the quality of life and clinical outcomes of elderly patients with CHF in primary care is necessary. TRIAL REGISTRATION: The Education Thérapeutique des patients Insuffisants Cardiaques (ETIC; Therapeutic Education for Patients with Cardiac Failure) trial is a cluster randomised controlled trial registered with ClinicalTrials.gov ( REGISTRATION NUMBER: NCT01065142 ) and the French Drug Agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé; REGISTRATION NUMBER: 2009-A01142-55).
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Vaillant-Roussel et al. (2016) conducted an RCT in Chronic heart failure (n=241). Patient education programme delivered by trained general practitioners vs. Routine care was evaluated on Quality of life measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) at 19 months (b = 1.19, 95% CI -5.94-8.32, p=0.74). A pragmatic patient education intervention delivered by trained general practitioners did not improve quality of life in elderly patients with stable chronic heart failure compared with routine care.
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