| Measure Description: Percentage of patients age ≥18 y with a diagnosis of heart failure who were provided with self-care education during ≥1 visits within a 12-mo period | |
| Numerator | Patients who were provided with self-care education* during $1 visits within a 12-mo period *Self-care education may include the following: Definition of heart failure (linking disease, symptoms, and treatment) and cause of patient’s heart failure; recognition of escalating symptoms and concrete plan for response to particular symptoms; indications and use of each medication; recommendations for modification of risks for heart failure progression; specific diet recommendations; individualized low-sodium diet; recommendation for alcohol intake; specific activity/exercise recommendations; importance of treatment adherence and behavioral strategies to promote treatment adherence; importance of monitoring weight daily at home. |
| Denominator | All patients age ≥18 y with a diagnosis of heart failure who were seen at least once for any visit within a 12-mo period |
| Denominator Exclusions | Heart transplant LVAD |
| Denominator Exceptions | Documentation of medical reason(s) for not providing self-care education (e.g., comfort care only, dementia, or cognitive impairment) Documentation of patient reason(s) for not providing self-care education (e.g., patient refusal) |
| Measurement Period | 12 mo |
| Sources of Data | EHR data Administrative data/claims (inpatient or outpatient claims) Administrative data/claims expanded (multiple sources) Paper medical record |
| Attribution | Individual practitioner Facility |
| Care Setting | Outpatient |
| Rationale | |
| Patient self-care education is a useful nonpharmacological component to heart failure care. It may reduce the likelihood of nonadherence with recommended therapeutic strategies and lead to early identification of worsening clinical status and subsequent treatment. Heart failure disease management programs, in which patient education is an integral component, have been shown to be effective in improving self-care and reducing readmissions (96). This measure is intended to highlight the importance of providing appropriate self-care education to patients with heart failure. The form and manner of education (e.g., counseling, information in the form of pamphlets or booklets) is at the discretion of the individual clinician and should be specific to the needs of the patient. Data from the IMPROVE-HF registry indicate that only 61% of outpatients with heart failure were provided with education (including discussion of salt-restricted diet, monitoring of daily weight, warning signs of worsened heart failure, and activity recommendations), with rates of adherence ranging from 0% to 100% among practices (97). A number of consensus groups/patient advocacy organizations have developed educational materials that are recommended to aid implementation of the measure. These materials/tools include, but are not limited to:
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| Clinical Recommendation(s) | |
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2013 ACCF/AHA heart failure clinical practice guideline (7) 1. Patients with HF should receive specific education to facilitate HF self-care (103–108). (Class 1, Level of Evidence: B) | |
ACC indicates American College of Cardiology; ACCF, American College of Cardiology Foundation; AHA, American Heart Association; EHR, electronic health record; HF, heart failure; HFSA, Heart Failure Society of America; IMPROVE-HF, Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting; LVAD, left ventricular assist device; and QM, quality measure.