Designing evidence-based self-care interventions for patients with heart failure

Introduction:

Heart failure (HF) can be managed effectively with proper self-care. However, HF patients are frequently unable to adhere to self-care recommendations. Previous self-care interventions aiming to enhance adherence have shown limited success, as they are often not theory-based. Thus, this study seeks to develop an intervention manual containing theory-based behaviour change interventions (BCIs) to improve self-care adherence.

Methods:

Based on a qualitative and quantitative meta-review, behaviours associated with (non)adherence to HF self-care were identified and extracted by two researchers independently and mapped onto the COM-B behaviour model to determine areas for change. Behaviours were then mapped onto appropriate behaviour change techniques (BCTs) using advice from patients and clinicians, to ensure clinical suitability. Finally, qualitative interviews, in combination with the Delphi technique, were conducted with patients and health professionals to fine-tune the content of BCIs and increase the likelihood of their acceptance.

Results:

A comprehensive intervention manual has been produced containing numerous BCTs that are relevant for enhancing adherence to HF related self-care recommendations. All BCTs are described according to the following eight descriptors to ensure reproducibility of the intervention: (1) content of elements of the intervention, (2) characteristics of self-care tutors, (3) characteristics of target population, (4) delivery location, (5) mode of delivery, (6) format, (7) intensity and (8) duration.

Discussion:

Subsequent studies are planned, including an exploratory trial to pilot test the interventions described in the manual, and a full randomised controlled trial. The BCIs are created to be implemented successfully into the German health care system.