Educational Program to Improve Heart Failure Outcomes in Adults Living in Rural Areas
Educational Program to Improve Heart Failure Outcomes in Adults Living in Rural Areas
Heart failure patients living in rural areas usually do not have adequate access to formal
 heart failure management programs. This study will compare two versions of an educational
 intervention aimed at improving self-care management techniques among individuals with heart
 failure who are living in rural areas.
Heart failure is a life-threatening condition in which the heart can no longer pump enough
 blood to the rest of the body. It is important for individuals with heart failure to closely
 monitor their symptoms and seek out medical attention when appropriate. Swelling and weight
 gain are common heart failure symptoms that indicate excess fluid buildup in the body and
 worsening heart function. Closely monitoring and responding to these symptoms can be a
 strategic way to prevent heart failure exacerbations. However, many patients ignore symptoms
 and are reluctant to seek care. Specialized monitoring programs can help heart failure
 patients to respond more appropriately to their symptoms.

 Traditionally, heart failure patients living in rural areas have had limited access to formal
 monitoring programs. Fluid Watchers is a program designed to help heart failure patients
 living in rural areas improve self-management of symptoms, specifically excess fluid buildup.
 The purpose of this study is to compare the effectiveness of two versions of Fluid Watchers
 at improving the hospitalization and death rates of individuals with heart failure who live
 in rural areas.

 In this 2-year study, 710 participants will be randomly assigned to either the Fluid Watchers
 LITE program, the Fluid Watchers PLUS program, or a usual care control group. Individuals in
 both Fluid Watchers groups will attend a one-on-one educational session that will include
 heart failure counseling and information on self-monitoring and care-seeking strategies.
 Participants in the PLUS program will receive additional counseling, audio tapes, and
 follow-up telephone calls on a biweekly basis. All participants will record self-monitoring
 adherence and contact with healthcare providers. Outcome measures will be assessed during
 either clinic or home visits at study entry and Months 3, 12, and 24, and will include number
 of emergency department visits, number of physician visits, heart failure severity, and
 quality of life.
Inclusion Criteria:

 -  Hospitalized for heart failure in the 6 months prior to study entry

 -  Able to read and write English

 -  Lives independently

 Exclusion Criteria:

 -  Current participation in a heart failure management program

 -  Impaired cognition

 -  Serious co-morbidity