An intervention for VA patients with congestive heart failure

Laurel A. Copeland, Gregory D. Berg, Donna M. Johnson, Richard L. Bauer

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Objective: To assess the effect of a telephone intervention to improve quality of life among patients with congestive heart failure (CHF). Study Design: Prospective randomized study. Methods: Single-site recruitment of 458 patients using veterans Health Administration care into a randomized controlled trial with a 1-year pre-intervention data collection period and a 1-year intervention and follow-up period. To compensate for imbalanced study groups, propensity scores were included in adjusted models of quality of life, satisfaction with care, inpatient utilization, survival, and costs of care. Results: Patients aged 45 to 95 years participated in the study; 22% were of Hispanic race/ethnicity, and 7% were African American. All but 5 were male, consistent with the older population among veterans. At baseline, 40% were in Goldman Specific Activity Scale class I, 42% were in class III, 6% were in class II or IV, and 12% were unclassified. Patients scored a mean (SD) of 14 (1.5) points below the norm on the physical component score. After the yearlong intervention, no differences in clinical outcomes were noted between the intervention group and the control group. The CHF-related costs were higher for the intervention group, as were overall costs that included the cost of the intervention. Intervention group patients reported better compliance with weight monitoring and exercise recommendations. Conclusions: A risk-stratified intervention for patients with CHF resulted in potential behavioral improvements but no survival benefit. A high-cost high-intensity intervention may be required to improve survival for patients with CHF. Inclusion of the costs of interventions is recommended for future researchers.

Original languageEnglish (US)
Pages (from-to)158-165
Number of pages8
JournalAmerican Journal of Managed Care
Volume16
Issue number3
StatePublished - Mar 1 2010

ASJC Scopus subject areas

  • Health Policy

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    Copeland, L. A., Berg, G. D., Johnson, D. M., & Bauer, R. L. (2010). An intervention for VA patients with congestive heart failure. American Journal of Managed Care, 16(3), 158-165.