P3770Post-discharge short service message improves short-term clinical outcome and self-care behavior in chinese patients with chronic heart failure

Abstract

Background: Chronic Heart failure (CHF) is associated with frequent hospitalization and high mortality rate. Self‐care behavior is an important part in CHF management. Telemedicine methods may have the potential in benefiting selfcare behavior and clinical outcome. Purpose: Short Message Service (SMS) would improve self‐care behavior and readmission‐free survival in patients with CHF. Methods: This was a randomized controlled trial. Between December 2011 to September 2015, the patients hospitalized with decompensated CHF in a tertiary referral hospital were enrolled and randomized to receive SMS, structured telephone support (STS), or usual care after discharge. Patients in the SMS group received short messages containing educational and reminding information repeatedly within one month. Follow‐up calls were made at 180 days after discharge. Primary endpoint was the 180‐day composite event, defined as all‐cause mortality or readmission. Secondary endpoints included the self‐care behavior and quality of life. Results: 767 patients (61±15 years, 56.5% male) were randomized: 252 patients received SMS, 255 received STS and 260 received usual care. During 180‐day follow up, 76 (9.9%) patients died and 274 (35.7%) patients had experienced readmission. Comparing to the usual care group, the composite event rate was significantly lower in the SMS and STS group (50.4% vs. 41.3% and 36.5%, both P<0.05), but no difference was observed between the two phone‐based intervention group (P=0.268). However, all‐cause mortality was not different among the three groups (control vs. SMS vs. STS: 10.8% vs. 10.3% vs. 8.6%, P=0.694). (Table presented) Although there was no difference between the two groups, better self‐care behavior was reported in the SMS and STS group when compared with the control group (medication compliance, 78.9% vs. 81.4% vs. 69.5%, P=0.011; water restriction, 70.8% vs. 74.5% vs. 61.5%, P=0.013). Quality of life was similar among the three groups (P=0.526). (Figure presented) Conclusions: In CHF patients, post‐discharge SMS reduced 180‐day composite event and improved self‐care behavior that appeared as efficient as STS.