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BACKGROUND: Although clinical guidelines recommend self-care assessment for patients with chronic heart failure (CHF), its prognostic significance remains controversial. This study aimed to compare the prognostic significance of self-care behavior on mortality between patients with and without a history of recent hospitalization for heart failure (HF). METHODS: We analyzed consecutive 1907 CHF patients from a Japanese multicenter registry (January 2020-June 2023) using the 9-item European Heart Failure Self-care Behavior Scale (EHFScBS-9) at enrolment. Suboptimal self-care behavior was defined as a score < 70 on the EHFScBS-9. Patients were divided into recent (within 30 days post-discharge, n = 664) and no recent hospitalization for HF groups (n = 1263), respectively. The primary outcome was a composite of all-cause death and rehospitalization for HF. RESULTS: During a median follow-up period of 427 (interquartile range 273-630) days, the primary outcome occurred in 100 patients. Patients with suboptimal self-care behavior exhibited a higher incidence of the primary outcome in the recent hospitalization for HF group (p = 0.020) but not in the no recent hospitalization for HF group (P = 0.16). Multivariable regressions showed suboptimal self-care behavior was independently associated with the primary outcome in the recent hospitalization for HF group with a significant interaction (P = 0.029). CONCLUSION: In patients recently hospitalized for HF, but not in those without a recent hospitalization history for HF, suboptimal self-care behavior was associated with adverse events. This indicates the importance of self-care education for these patients.
RESUMO
AIM: To determine a possibility for improving the capability of patients with chronic heart failure (CHF) for self-care and self-control using a remote monitoring platform on a basis of mobile application. MATERIALS AND METHODS: The study included 142 patients with CHF of different etiology. During the stay in hospital, patients attended structured classes on different aspects of self-control and self-care in CHF. The group of active management consisted of 47 patients who subsequently used a version of mobile application. The control group consisted of 95 patients with CHF. The remote monitoring platform was based on a translated to Russian version of the European Heart Failure Self-Care Behavior Scale (EHFScBS_9), which included 9 items addressing different issues of selfcontrol. Responses were presented as a scale ranging from "completely agree" (1) to "completely disagree (5). The total score was calculated by adding scores for each item. The lower the score the better was the capability of CHF patients for self-care. The followup duration was 6 months. RESULTS: On admission, the mean EHFScBS_9 score decreased to 15±2.3 in the mobile application group whereas in the control group, the mean score was 23.95±3.02, which indicated a significantly better capability for self-care in the mobile application group (p.