Top Things to Know: Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management

Published: July 19, 2017

  1. Cardiovascular disease (CVD) is a leading cause of mortality and disability in the United States.
  2. According to NHANES 2011 – 2014 data, an estimated 92.1 million Americans have more than one type of CVD and the mortality for total CVD in 2014 was over 800,000.1
  3. Therapeutic patient education (TPE) is an approach to facilitate patient and family learning about the treatment of disease and the adoption of self-management behaviors and lifestyles to improve physical and psychological health outcomes (e.g. biomarkers, quality of life).
  4. The purpose of this paper was to review and analyze published research studies of TPE for self-management in selected cardiovascular (CV) conditions and then to understand the most beneficial approaches to implementing TPE.
  5. Healthcare reforms have increasingly shifted responsibility for self-management to patients and families as hospital stays and ambulatory visits have become shorter and less frequent.
  6. The goal of TPE is to improve health outcomes, including preventing avoidable complications.
  7. Self-management of CVD and other chronic diseases requires patients to have (1) knowledge of their disease process and management, (2) self-management skills to apply this knowledge to their daily life, and (3) confidence that they can sustain self-management behaviors to maintain and improve their health status.
  8. The selected cardiac populations analyzed for this paper include: CVD (acute coronary artery syndrome (ACS), hypertension, atrial fibrillation, heart failure, and CVD treatments (coronary artery bypass graft surgery and percutaneous coronary intervention.
  9. Three questions were assessed in the integrative review of the literature:
    • What TPE interventions have been used to promote self-management in select CV populations?
    • What is the impact of TPE for self-management on outcomes for select CV populations?
    • How are common barriers to implementing TPE for CV patients managed?
  10. Several variables for successful implementation of TPE for self-management are discussed, and recommendations are made for implementing TPE directed toward self-management in clinical practice.

Citation


Barnason S, White-Williams C, Rossi LP, Centeno M, Crabbe DL, Lee KS, McCabe N, Nauser J, Schulz P, Stamp K, Wood K; on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Clinical Cardiology; and Stroke Council. Evidence for therapeutic patient education interventions to promote cardiovascular patient self-management: a scientific statement for healthcare professionals from the American Heart Association [published online ahead of print June 19, 2017]. Circ Cardiovasc Qual Outcomes, doi: 10.1161/HCQ.0000000000000025.