Targeted intervention improves knowledge but not self-care or readmissions in heart failure patients with mild cognitive impairment

Karen K. Davis, Miriam Mintzer, Cheryl Renee Dennison-Himmelfarb, Matthew J. Hayat, Stacey Rotman, Jerilyn K. Allen

Research output: Contribution to journalArticle

Abstract

Aims Mild cognitive impairment (MCI) is prevalent in heart failure, and can contribute to poor self-care and higher hospital readmissions. Strategies to improve self-care in patients with MCI have not been studied. This randomized controlled trial aimed to test the effect of a targeted intervention on self-care, heart failure knowledge, and 30-day readmissions. Methods and results The study included 125 patients hospitalized for exacerbation of heart failure who screened positive for MCI. The treatment group received a targeted self-care teaching intervention using principles of cognitive training. Self-care, heart failure knowledge, depression, and social support were assessed at baseline and 30 days post-discharge. Mean heart failure knowledge scores improved significantly in the intervention group, but decreased in the control group (P <0.001). When controlling for other variables, patients in the intervention group showed a greater increase in heart failure knowledge than patients in the control group (P 0.027). Black race was significantly associated with lower heart failure knowledge scores (P 0.030). Mean change scores for self-care showed greater improvement in the intervention group when compared with the control group; however, this was not statistically significant. There was no difference in readmission rates between the groups. Conclusion It is feasible to conduct a randomized controlled trial in patients with MCI. Patients in the treatment group had greater heart failure knowledge at 30 days post-discharge; however, this did not impact readmission rates. Further research is needed to describe how MCI affects self-care and knowledge, and how race and other factors may influence outcomes in this population.

Original languageEnglish (US)
Pages (from-to)1041-1049
Number of pages9
JournalEuropean Journal of Heart Failure
Volume14
Issue number9
DOIs
StatePublished - Sep 2012

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Self Care
Heart Failure
Control Groups
Randomized Controlled Trials
Patient Readmission
Cognitive Dysfunction
Social Support
Teaching
Depression
Therapeutics
Research
Population

Keywords

  • Cognitive impairment
  • Cognitive training
  • Heart failure
  • Self-care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Targeted intervention improves knowledge but not self-care or readmissions in heart failure patients with mild cognitive impairment. / Davis, Karen K.; Mintzer, Miriam; Dennison-Himmelfarb, Cheryl Renee; Hayat, Matthew J.; Rotman, Stacey; Allen, Jerilyn K.

In: European Journal of Heart Failure, Vol. 14, No. 9, 09.2012, p. 1041-1049.

Research output: Contribution to journalArticle

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