161726 Goal Setting and Life Style Changes for Self-Management in Heart Failure Patients with Metabolic Syndrome

Tuesday, November 6, 2007: 5:00 PM

Evan M. Ehsani, BS, CHES , Health and Kinesiology/Endocrinology-Cardiology, Texas A&M University/Baylor College of Medicine, College station, TX
Gabriel Anzueto, BS , Endocrinology-Cardiology, Baylor College of Medicine, Houston, TX
Ranjita Misra, PhD , Health and Kinesiology, Texas A&M University, College Station, TX
Nalini Ramaswami, MD , Endocrinology, Baylor College of Medicine, Houston, TX
Ashok Balasubramanyam, MD , Division of Diabetes, Endocrinology & Metabolism, Baylor College of Medicine, Houston, TX
Allison M. Pritchett, MD , Cardiology, Baylor College of Medicine, Houston, TX
The prevalence of heart failure and metabolic syndrome has significantly increased in the US, creating a unique situation for patients battling both conditions. Behavioral factors such as noncompliance with medications, diet and delay in seeking preventive care may contribute to hospital readmissions and premature mortality. Thus patients with heart failure and metabolic syndrome could benefit from education that stresses effective self-management in the context of aggressive multidisciplinary care. The purpose of this study was to examine the impact of patient education using realistic, incremental goal setting to achieve increased self-confidence and subsequent improvements in patient lifestyle and management techniques. Health education for secondary and tertiary prevention by trained health educators (instead of Nurses) was conducted as part of a multidisciplinary team. Respondents comprised 72 patients at Ben Taub General Hospital randomized to either usual care (usual doctor; n=36) or collaborative care (multidisciplinary team: heart failure-cardiologist, metabolic syndrome-endocrinologist, case manager, and health educator; n=36). Mean age of respondents in collaborative care was 53.5 (SD=9.3). The majority were high school educated (mean = 11.5 years), females (55%), no health insurance (45%), and minorities (34% Hispanic & 51% African Americans).The multidisciplinary team agreed on nine important goals: medication compliance, increased exercise, sodium reduction, diabetic diet, weight loss, smoking cessation, eye exams, dental exams and weight monitoring. Collaborative care (n=36): 41.6% patients set goals, 8.3% achieved those goals, 22.2% set a second goal and 8.3% achieved that second goal. The most common goals chosen by patients included sodium reduction, diabetic diet and medication compliance.

Learning Objectives:
Learning Objectives At the conclusion of the session, the participant (learner) in this session will be able to: 1. List the differences in care approach by usual care and collaborative care. 2. Describe the goals agreed by the multidisciplinary team for lifestyle improvements and confidence building. 3. Discuss the goals commonly chosen by patients for lifestyle changes.

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.