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European Journal of Heart Failure Advance Access originally published online on April 9, 2009
European Journal of Heart Failure 2009 11(6):609-616; doi:10.1093/eurjhf/hfp047
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

The impact of a self-management group programme on health behaviour and healthcare utilization among congestive heart failure patients

Esther S.T.F. Smeulders1,*, Jolanda C.M. van Haastregt1, Ton Ambergen2, Josiane J.J. Janssen-Boyne3, Jacques Th.M. van Eijk4 and Gertrudis I.J.M. Kempen1

1 Department of Health Care and Nursing Science, School for Public Health and Primary Care: CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, Maastricht 6200 MD, The Netherlands
2 Department of Methodology and Statistics, School for Public Health and Primary Care: CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
3 Department of Cardiology, Department of Integrated Care, University Hospital Maastricht, Maastricht, The Netherlands
4 Department of Social Medicine, School for Public Health and Primary Care: CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

* Corresponding author. Email: e.smeulders{at}zw.unimaas.nl


  Abstract

Aims: The ‘Chronic Disease Self-Management Programme’ (CDSMP) emphasizes patients’ responsibility for the day-to-day management of their condition(s) and has shown favourable effects on health behaviour and healthcare utilization among various groups of patients with chronic conditions. However, the effects of the CDSMP among congestive heart failure (CHF) patients are unknown. We therefore aimed to assess the effects of the CDSMP on health behaviour and healthcare utilization in patients with CHF.

Methods and results: This randomized, controlled trial with 12 months of follow-up included 317 CHF patients with a slight to marked limitation of physical activity. Control patients (n = 131) received usual care, consisting of regular checkups at an outpatient clinic. Intervention group patients (n = 186) received usual care and participated in a 6-week self-management group programme. Favourable effects on walking for exercise and other physical activities such as aerobic, stretching, and strength exercises, sports, and gardening were reported in the intervention group immediately after completion of the programme. The effect of the programme on other physical activities extended to 6 months of follow-up. No favourable effects were found for the other outcomes.

Conclusion: The CDSMP significantly improved physical activity among CHF patients for up to 6 months after the end of the programme; however, it did not affect other health behaviour outcomes or healthcare utilization.

Key Words: Heart failure • Randomized, controlled trial • Self-management • Health behaviour • Healthcare utilization

Received September 1, 2008; Revised February 9, 2009; Accepted February 16, 2009


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