PMID- 33516189 OWN - NLM STAT- MEDLINE DCOM- 20210614 LR - 20210614 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 21 IP - 1 DP - 2021 Jan 30 TI - Assessment of chronic disease self-management in patients with chronic heart failure based on the MCID of patient-reported outcomes by the multilevel model. PG - 58 LID - 10.1186/s12872-021-01872-3 [doi] LID - 58 AB - PURPOSE: The minimal clinically important difference (MCID) of a patient-reported outcome (PRO) represents the threshold value of the change in the score for that PRO. It is deemed to have an important implication in clinical management. This study was performed to evaluate the clinical significance of chronic disease self-management (CDSM) for patients with chronic heart failure based on the MCID of the chronic heart failure-PRO measure (CHF-PROM). METHODS: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from July 2018. Advice of CDSM was provided in written form at discharge to all patients. Information regarding CHF-PROM and CDSM were collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of CDSM for CHF-PROM scores, as well as its physical and psychological domains. MCID changes of the PRO were introduced and compared with beta values of CDSM obtained from the multi-level models to further evaluate the clinical significance. The STROBE checklist is shown in Additional file 1. RESULTS: Scores for CHF-PROM improved significantly after discharge. The multilevel models showed that a regular schedule, avoidance of over-eating, a low-sodium diet and exercise increased scores on CHF-PROM. Compared with the MCID, avoidance of over-eating (12.39 vs. 9.75) and maintenance of a regular schedule often (10.98 vs. 9.75), and exercise almost every day (11.36 vs. 9.75) reached clinical significance for the overall summary. Avoidance of over-eating (5.88 vs. 4.79) and a regular schedule almost every day (4.96 vs. 4.79) reached clinical significance for the physical scores. Avoidance of over-eating half of the time (5.26 vs. 4.87) and a regular schedule almost every day (5.84 vs. 4.87) demonstrated clinical significance for the psychological scores. CONCLUSIONS: This study observed an association of avoidance of over-eating and maintenance of a regular schedule with the improvement of CHF-PROM. It provides further evidence for management of heart failure. TRIAL REGISTRATION: Current Prospective Trials NCT02878811; registered August 25, 2016; https://clinicaltrials.gov/ct2/show/NCT02878811?term=NCT02878811&draw=2&rank=1 . FAU - Tian, Jing AU - Tian J AD - Department of Cardiology, The 1St Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, 030001, Shanxi Province, China. AD - Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, 56 South XinJian Road, Taiyuan, 030001, Shanxi Province, China. FAU - Zhao, Jinghua AU - Zhao J AD - Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, Shanxi Province, China. FAU - Zhang, Qing AU - Zhang Q AD - Department of Cardiology, The 1St Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, 030001, Shanxi Province, China. FAU - Ren, Jia AU - Ren J AD - Department of Cardiology, The 1St Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, 030001, Shanxi Province, China. FAU - Han, Linai AU - Han L AD - Department of Cardiology, The 1St Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, 030001, Shanxi Province, China. FAU - Li, Jing AU - Li J AD - Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, Shanxi Province, China. FAU - Zhang, Yanbo AU - Zhang Y AUID- ORCID: 0000-0002-9461-4163 AD - Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, 030001, Shanxi Province, China. sxmuzyb@126.com. AD - Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, 56 South XinJian Road, Taiyuan, 030001, Shanxi Province, China. sxmuzyb@126.com. FAU - Han, Qinghua AU - Han Q AD - Department of Cardiology, The 1St Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, 030001, Shanxi Province, China. syhqn@sohu.com. LA - eng SI - ClinicalTrials.gov/NCT02878811 GR - 81872714/Innovative Research Group Project of the National Natural Science Foundation of China/ GR - 201801D221423/Natural Science Foundation of Shanxi Province/ GR - 2016YFC090310/Natural Science Foundation of Shanxi Province/ GR - YDZX20191400004850/Natural Science Foundation of Shanxi Province/ PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20210130 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Aged MH - Aged, 80 and over MH - China MH - Chronic Disease MH - Diet, Sodium-Restricted MH - Exercise MH - Feeding Behavior MH - Female MH - *Healthy Lifestyle MH - Heart Failure/diagnosis/physiopathology/psychology/*therapy MH - Humans MH - Hyperphagia/physiopathology/prevention & control/psychology MH - Male MH - Middle Aged MH - *Minimal Clinically Important Difference MH - Patient Discharge MH - *Patient Reported Outcome Measures MH - Prospective Studies MH - *Risk Reduction Behavior MH - *Self-Management MH - Time Factors MH - Treatment Outcome PMC - PMC7847136 OTO - NOTNLM OT - Chronic disease self-management OT - Chronic heart failure OT - Minimal clinically important difference OT - Multilevel model OT - Patient-reported outcome COIS- The authors declare that they have no competing interests. EDAT- 2021/02/01 06:00 MHDA- 2021/06/16 06:00 PMCR- 2021/01/30 CRDT- 2021/01/31 20:20 PHST- 2020/07/04 00:00 [received] PHST- 2021/01/18 00:00 [accepted] PHST- 2021/01/31 20:20 [entrez] PHST- 2021/02/01 06:00 [pubmed] PHST- 2021/06/16 06:00 [medline] PHST- 2021/01/30 00:00 [pmc-release] AID - 10.1186/s12872-021-01872-3 [pii] AID - 1872 [pii] AID - 10.1186/s12872-021-01872-3 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2021 Jan 30;21(1):58. doi: 10.1186/s12872-021-01872-3.