A comprehensive symptom diary intervention to improve outcomes in patients with HF: a pilot study

Abstract

Background: Patients with heart failure must monitor for and recognize escalating symptoms to take action to relieve symptoms and decrease hospitalizations. However, symptom monitoring is not commonly performed. One way to promote patients' engagement in symptom monitoring is by providing a symptom diary.

Purpose: The aim of this study was to test the effect of a comprehensive daily symptom diary intervention on event-free survival and health-related quality of life (HRQOL).

Methods: Patients were randomized into either intervention (n = 23) or usual-care groups (n = 21). The intervention group received a symptom diary with self-care education and counseling at baseline with 5 follow-up calls for 3 months. All patients were interviewed to obtain survival data at 1 month and 3 months. HRQOL was measured at baseline, 1 month, and 3 months. Kaplan-Meier curves with the log-rank test were used to compare group differences in time to first event. Linear mixed models were conducted to examine the relationship between groups and changes in HRQOL over 3 months.

Results: The intervention group had longer event-free survival than the usual-care group (P = .03). There were no differences in changes in HRQOL scores between the groups over 3 months.

Conclusions: Positive effects of the intervention on survival were found. However, there was no significant difference in changes in HRQOL.

Keywords: Heart failure; outcome; self-care; symptoms and signs.