Reciprocal peer support (with only 55% patient engagement) did not improve time-to-first all-cause rehospitalization or death compared with usual nurse care management in heart failure patients.
RCT
Does reciprocal peer support reduce all-cause rehospitalization or death in patients recently hospitalized for heart failure?
A reciprocal peer support program for patients recently hospitalized with heart failure had low patient engagement and did not improve clinical outcomes or quality of life compared to usual nurse care management.
BACKGROUND: Although disease management programs for patients hospitalized with heart failure (HF) are effective, they are, however, often resource intensive, limiting their uptake. Peer support programs have led to improved outcomes among patients with other chronic conditions and may result in similar improvements for patients with HF. METHODS AND RESULTS: In this randomized controlled trial, reciprocal peer support (RPS) arm patients participated in a HF nurse practitioner-led goal setting group session, received brief training in peer communication skills, and were paired with another participant in their cohort with whom they were encouraged to talk weekly using a telephone platform. Participants were also encouraged to attend 3 nurse practitioner-facilitated peer support group sessions. Patients in the nurse care management arm attended a nurse practitioner-led session to address their HF care questions and receive HF educational materials and information on how to access care management services. The median age of the patients was 69 years; 51% were female and 26% were racial/ethnic minorities. Only 55% of RPS patients participated in peer calls or group sessions. In intention-to-treat analyses, the RPS and nurse care management groups did not differ in time-to-first all-cause rehospitalization or death or in mean numbers of rehospitalizations or deaths. There were no differences in improvements in 6-month measures of HF-specific quality of life or social support. Conclusions- Among patients recently hospitalized for HF, more than half of RPS participants had no or minimal engagement with the RPS program, and the program did not improve outcomes compared with usual HF nurse care management. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. UNIQUE IDENTIFIER: NCT00508508.
Heisler et al. (Thu,) conducted a rct in Heart failure. Reciprocal peer support (RPS) vs. Usual HF nurse care management was evaluated on Time-to-first all-cause rehospitalization or death. Reciprocal peer support (with only 55% patient engagement) did not improve time-to-first all-cause rehospitalization or death compared with usual nurse care management in heart failure patients.