Design of a Multiple-Behavior Change Intervention for Supporting Self-management in Patients With Chronic Heart Failure: An Intervention Mapping Approach.
Joëlle Dam, Thijs M H Eijsvogels, Marjolein H I Verdijk and 5 others
PMID 38488396WHAT IT FOUND
Development testing found a nurse-delivered heart failure programme targeting medication and physical activity feasible and acceptable, but it has not been shown to improve patient outcomes.
Key findings
01AIMS-CHF was adapted to focus on medication adherence and physical activity because symptom monitoring and timely healthcare seeking were already adequately covered in routine care.
02Feasibility testing found the medication monitor easy to use and not burdensome, although some patients wanted direct feedback; the activity tracker was easy and motivating, but downloading its data was more complex and nurses needed an instruction manual.
03The final protocol is delivered by trained heart failure nurses during routine clinic visits, introduces medication adherence and physical activity in consecutive visits, and includes a follow-up phone call after the first visits.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The article reports intervention development and feasibility, not a test of clinical effectiveness in chronic heart failure. Advisory board participants were selected nurses and patients, so their feedback may not represent less motivated or more complex patients and nurses. The medication monitor required a manual button press, so forgotten presses could underestimate true adherence. The activity tracker was commercial and its software was not designed for clinical use; some patients may need help installing and using the smartphone application. The authors relied on existing reviews, qualitative studies, and advisory boards rather than conducting their own systematic review or qualitative study.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as evidence that the intervention improves medication adherence, physical activity, or heart failure outcomes. It reports intervention development and feasibility testing, and effectiveness in chronic heart failure still requires a future trial.