Improvement in Kansas City Cardiomyopathy Questionnaire Scores After a Self-Care Intervention in Patients With Acute Heart Failure Discharged From the Emergency Department

William B Stubblefield; Cathy A Jenkins; Dandan Liu; Alan B Storrow; John A Spertus; Peter S Pang; Phillip D Levy; Javed Butler; Anna Marie Chang; Douglas Char; Deborah B Diercks; Gregory J Fermann; Jin H Han; Brian C Hiestand; Christopher J Hogan; Yosef Khan; Sangil Lee; JoAnn M Lindenfeld; Candace D McNaughton; Karen Miller; W Frank Peacock; Jon W Schrock; Wesley H Self; Adam J Singer; Sarah A Sterling; Sean P Collins

doi:10.1161/CIRCOUTCOMES.121.007956

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Improvement in Kansas City Cardiomyopathy Questionnaire Scores After a Self-Care Intervention in Patients With Acute Heart Failure Discharged From the Emergency Department

Journal article

Open access

Improvement in Kansas City Cardiomyopathy Questionnaire Scores After a Self-Care Intervention in Patients With Acute Heart Failure Discharged From the Emergency Department

William B Stubblefield, Cathy A Jenkins, Dandan Liu, Alan B Storrow, John A Spertus, Peter S Pang, Phillip D Levy, Javed Butler, Anna Marie Chang, Douglas Char, …

Circulation Cardiovascular quality and outcomes, Vol.14(10), pp.e007956-1041

10/2021

DOI: 10.1161/CIRCOUTCOMES.121.007956

PMCID: PMC8628372

PMID: 34555929

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Abstract

We conducted a secondary analysis of changes in the Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 over 30 days in a randomized trial of self-care coaching versus structured usual care in patients with acute heart failure who were discharged from the emergency department. Patients in 15 emergency departments completed the KCCQ-12 at emergency department discharge and at 30 days. We compared change in KCCQ-12 scores between the intervention and usual care arms, adjusted for enrollment KCCQ-12 and demographic characteristics. We used linear regression to describe changes in KCCQ-12 summary scores and logistic regression to characterize clinically meaningful KCCQ-12 subdomain changes at 30 days. There were 350 patients with both enrollment and 30-day KCCQ summary scores available; 166 allocated to usual care and 184 to the intervention arm. Median age was 64 years (interquartile range, 55-70), 37% were female participants, 63% were Black, median KCCQ-12 summary score at enrollment was 47 (interquartile range, 33-64). Self-care coaching resulted in significantly greater improvement in health status compared with structured usual care (5.4-point greater improvement, 95% CI, 1.12-9.68; =0.01). Improvements in health status in the intervention arm were driven by improvements within the symptom frequency (adjusted odds ratio, 1.62 [95% CI, 1.01-2.59]) and quality of life (adjusted odds ratio, 2.39 [95% CI, 1.46-3.90]) subdomains. In this secondary analysis, patients with acute heart failure who received a tailored, self-care intervention after emergency department discharge had clinically significant improvements in health status at 30 days compared with structured usual care largely due to improvements within the symptom frequency and quality of life subdomains of the KCCQ-12. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02519283.

Cardiomyopathies

Emergency Service, Hospital

Female

Health Status

Heart Failure - diagnosis

Heart Failure - therapy

Humans

Kansas

Middle Aged

Patient Discharge

Quality of Life

Self Care

Surveys and Questionnaires

Treatment Outcome

Details

Title: Subtitle: Improvement in Kansas City Cardiomyopathy Questionnaire Scores After a Self-Care Intervention in Patients With Acute Heart Failure Discharged From the Emergency Department
Creators: William B Stubblefield - Vanderbilt University Medical Center
Cathy A Jenkins - Vanderbilt University Medical Center
Dandan Liu - Vanderbilt University Medical Center
Alan B Storrow - Vanderbilt University Medical Center
John A Spertus - University of Missouri–Kansas City
Peter S Pang - Indiana University
Phillip D Levy - Wayne State University
Javed Butler - University of Mississippi Medical Center
Anna Marie Chang - Thomas Jefferson University Hospital
Douglas Char - University of Washington
Deborah B Diercks - Southwestern Medical Center
Gregory J Fermann - University of Cincinnati
Jin H Han - Vanderbilt University Medical Center
Brian C Hiestand - Wake Forest University
Christopher J Hogan - Virginia Commonwealth University Medical Center
Yosef Khan - American Heart Association
Sangil Lee - University of Iowa
JoAnn M Lindenfeld - Vanderbilt University Medical Center
Candace D McNaughton - Vanderbilt University Medical Center
Karen Miller - Vanderbilt University Medical Center
W Frank Peacock - Baylor College of Medicine
Jon W Schrock - MetroHealth Medical Center
Wesley H Self - Vanderbilt University Medical Center
Adam J Singer - Stony Brook University
Sarah A Sterling - University of Mississippi Medical Center
Sean P Collins - Vanderbilt University Medical Center
Resource Type: Journal article
Publication Details: Circulation Cardiovascular quality and outcomes, Vol.14(10), pp.e007956-1041
DOI: 10.1161/CIRCOUTCOMES.121.007956
PMID: 34555929
PMCID: PMC8628372
NLM abbreviation: Circ Cardiovasc Qual Outcomes
ISSN: 1941-7705
eISSN: 1941-7705
Grant note: R01 AG065249 / NIA NIH HHS AD-1409-21656 / Patient-Centered Outcomes Research Institute T32 HL087738 / NHLBI NIH HHS R56 HL141567 / NHLBI NIH HHS U54 GM115428 / NIGMS NIH HHS UL1 TR000445 / NCATS NIH HHS
Language: English
Date published: 10/2021
Academic Unit: Emergency Medicine; Injury Prevention Research Center
Record Identifier: 9984296971702771

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