Key result
Low-sustained self-care behaviors linked to ~177% increase in 1-year unplanned readmissions vs high-stable trajectories.
Why the study?
Long-term trajectories of self-care behaviours and their influence on hospital readmissions are limited in patients with heart failure.
Does a low-sustained self-care behaviour trajectory increase unplanned hospital readmissions in patients with heart failure?
Observational (n=137)
Does a low-sustained self-care behaviour trajectory increase unplanned hospital readmissions in patients with heart failure?
Hazard Ratio: 2.77
Patients with heart failure who exhibit low-sustained self-care behaviours have a nearly threefold higher risk of unplanned hospital readmissions within 1 year compared to those with high-stable behaviours.
May support monitoring self-care trajectories in HF; leaves open whether modification reduces readmissions.
AIM AND OBJECTIVES: This study aimed to identify the associations between longitudinal trajectories of self-care behaviours and unplanned hospital readmissions in patients with heart failure. BACKGROUND: Adherence to self-care behaviours is crucial to prevent hospital readmissions; however, self-care behaviours remain unsatisfactory among patients with heart failure. Studies of long-term trajectories of self-care behaviours and their influence on hospital readmissions are limited in this population. DESIGN: A prospective, longitudinal observational study. METHODS: Among 137 participants with heart failure (mean age 67.36 years, 62% men), we analysed the 1-year follow-up data to determine the association between 1-year trajectories of self-care behaviours and hospital readmissions using Kaplan-Meier analysis and multivariable Cox regression, adjusted for confounding variables. RESULTS: Self-care behaviour trajectories of heart failure patients were classified as 'high-stable' (58.4%) or 'low-sustained' (41.6%). The cumulative rate of readmissions for the low-sustained class was higher than that of the high-stable class for all periods. Factors influencing readmissions included anaemia, cognitive function, frailty and self-care behaviours trajectories. The low-sustained class had a 2.77 times higher risk of readmissions within 1 year than that in the high-stable class. CONCLUSIONS: Longitudinal self-care behaviours pattern trajectories of heart failure patients were stratified as high-stable and low-sustained. Routine follow-up assessment of patients' self-care behavioural patterns, including anaemia and frailty, and cognitive function can minimise unplanned hospital readmissions. RELEVANCE TO CLINICAL PRACTICE: Identification of trajectory patterns of self-care behaviours over time and provision of timely and individualised care can reduce readmissions for heart failure patients. Healthcare professionals should recognise the significance of developing tailored strategies incorporating longitudinal self-care behavioural patterns in heart failure patients. REPORTING METHOD: The study has been reported in accordance with the STROBE checklist (Appendix S1). PATIENT OR PUBLIC CONTRIBUTION: Patients have completed a self-reported questionnaire after providing informed consent.
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Son et al. (2023) conducted an observational in heart failure (n=137). Low-sustained self-care behaviour trajectory vs. High-stable self-care behaviour trajectory was evaluated on unplanned hospital readmissions (HR 2.77). A low-sustained trajectory of self-care behaviours was associated with a 2.77 times higher risk of unplanned hospital readmissions within 1 year compared to a high-stable trajectory.
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