UCSF

Background: Heart failure (HF) is a chronic and costly condition that affects approximately 5.8 million people in the United States with an additional 670,000 diagnosed each year. With a 30-day hospital readmission rate of 21%, the importance of determining effective means of preventing readmissions is imperative. Despite published guidelines emphasizing the importance of education in preventing readmissions, the most effective means of educating hospitalized patients with HF about their self-care remains unknown.

Objective: The objective of this study was to determine if hospitalized HF patients educated with the teach-back method retain self-care educational information and whether it is associated with fewer hospital readmissions.

Methods: A prospective cohort study design was utilized and included 276 patients hospitalized with HF over a 13-month period. Patients were educated and evaluated using the teach-back method as part of usual care. Data were collected related to their ability to recall educational information while hospitalized and during follow-up approximately seven days after hospital discharge. Readmissions were confirmed through follow-up phone calls and review of electronic medical records.

Results: Patients correctly answered three out of four or 75% of self-care teach-back questions 84.4% of the time while hospitalized and 77.1% of the time during follow-up phone call. More time spent teaching was significantly associated with correctly answered questions (p<0.001). Patients answering teach-back questions correctly while hospitalized and during follow-up had non-significant (p=0.775 and p=0.609) reductions in all-cause 30-day hospital readmission rates but a trend toward significance (p=0.15) was found in patients who had readmissions for HF.

Conclusions: The teach-back method is an effective method and tool to assess learning in hospitalized HF patients. Patients whose education is over a longer period retain significantly more information than those with briefer teaching. Correctly answering HF specific teach-back questions is not associated with reductions in 30-day hospital readmission rates. Future studies that include patients randomized to receive usual care or teach-back education to compare readmissions, deaths, and knowledge acquisition would provide an educational comparison between the groups.