Does Patient-Centered Educational Intervention Affect Clinical Outcome of Egyptian Patients with Heart Failure?

Background: Patient-centered education helps patients understand their problem and reach shared decisions on self-monitoring and management. The objective was to evaluate the effect of patient-centered education on self-care behavior, symptoms severity and need for hospitalization. Methods: A quasi-interventional study was done among patients attending the outpatient clinic, Zagazig University hospital. Patients were alternatively allocated to the intervention or control groups. Intervention group received patient-centered care while control group received classic consultations. Patients at pre- and post-intervention phases underwent assessment of self-care behavior using self-care of HF index (SCHFI) and New York Heart Association (NYHA) class. Hospital admission data were collected from the hospital electronic medical records. Results: A total of 95 patients were included; 49 intervention and 46 control patients. The average age was 53.6±12.8 years in the intervention patients (51% females) and 53.2±15.3 years in the control patients (69.6% females). Pre-intervention scores of SCHFI domains did not significantly differ between intervention and control groups. Post-intervention adequacy of self-care behavior among the control group did not significantly change. For the post-intervention adequacy in the intervention group, 40.8% achieved adequacy in self-care maintenance behavior, 59.2% adequately practiced self-care management, and 91.8% had adequate self-care confidence behavior. About 41% showed improvement in NYHA class vs 15.2% of control group (P=0.005). At 9-month, 4.1% of the intervention group were admitted more than one time vs 23.9% of control group (P=0.01). Conclusions: Patient-centered approach can effectively enable patients with HF to adopt adequate self-care behavior and to have a favorable clinical outcome.