Effect and Cost Effectiveness of a Dyadic Empowerment-based Heart Failure Management Program for Self-care

Summary

Global population aging has drastically increased healthcare spending worldwide, with the greatest portion going to hospital and community health services. Heart failure (HF), as the final form of many cardiovascular diseases resulting from insufficient myocardial pumping. Ineffective self-care is consistently identified as the major modifiable risk factor for HF decompensation requiring hospitalization. It refers to an active cognitive process that influence patients' engagement in self-care maintenance, symptom perception and self-care management. However, current studies pay much focus on interventions such as motivational interviewing and behavioural activation to enhance the HF-related self-care and health outcomes which only produces short-term benefits. In fact, the lack of a sustainable effect from the self-care supportive interventions might be related the use of patient-centric design in these studies, which totally ignores the fact that HF management takes place in a dyadic context. To advance, active strategies were adopted to mobilize collaborative effort of the dyad in actual disease management. This study aims to evaluate the effects and cost-effectiveness of a Dyadic empowerment-based Heart Failure Management Program (De-HF) for self-care, health outcomes, and health service utilization among HF patients who require family support after hospital discharge. The De-HF program is based on the Theory of Dyadic Illness Management to enhance the congruence in illness perception and active dyadic collaboration in managing HF via both face-to-face and online platforms.

Eligibility

Inclusion Criteria:

* Aged 18 or above
* Confirmed medical diagnosis of Heart Failure by a cardiologist of at least 3 months
* New York Heart Association (NYHA) Class II-IV symptoms
* Discharged home after an admission to the recruitment setting
* Carer co-residing with the patients in the same household
* Carer self-identified as the primary carer for the patients
* Both the patient and the carer having adequate cognitive ability (as indicated by an Abbreviated Test Score of \>6)
* Have at least one Smartphone or device to access the online meetings and videos

Exclusion Criteria:

* Not living with primary caregiver
* With end-stage renal disease relying on hemodialysis rather than HF medications to regulate fluid volume.

Conditions6

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