Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia

Dessie, Getenet and Burrowes, Sahai and Mulugeta, Henok and Haile, Dessalegn and Negess, Ayenew and Jara, Dubie and Alem, Girma and Tesfaye, Bekele and Zeleke, Haymanot and Gualu, Tenaw and Getaneh, Temsgen and Kibret, Getiye Dejenu and Amare, Desalegne and Mengesha, Endalkachew Worku and Wagnew, Fasil and Khanam, Rasheda ORCID: https://orcid.org/0000-0003-1130-2357 (2021) Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia. BMC Cardiovascular Disorder, 21:374. pp. 1-11. ISSN 1471-2261

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As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia.

To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale.

Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25, p < 0.05), taking aspirin (β = 0.76, p < 0.05), and having a history of hospitalization (β = 0.91, p < 0.05).

We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Current - Faculty of Business, Education, Law and Arts - School of Business (18 Jan 2021 -)
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 05 Aug 2021 01:03
Last Modified: 29 Oct 2021 01:33
Uncontrolled Keywords: Heart failure, Self-care adherence, Self-care education, Ethiopia
Fields of Research (2008): 14 Economics > 1402 Applied Economics > 140208 Health Economics
Fields of Research (2020): 38 ECONOMICS > 3801 Applied economics > 380108 Health economics
Identification Number or DOI: https://doi.org/10.1186/s12872-021-02170-8
URI: http://eprints.usq.edu.au/id/eprint/43087

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