{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:46:45Z","timestamp":1783532805365,"version":"3.55.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>We conducted a secondary analysis of changes in the Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 over 30 days in a randomized trial of self-care coaching versus structured usual care in patients with acute heart failure who were discharged from the emergency department.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Patients in 15 emergency departments completed the KCCQ-12 at emergency department discharge and at 30 days. We compared change in KCCQ-12 scores between the intervention and usual care arms, adjusted for enrollment KCCQ-12 and demographic characteristics. We used linear regression to describe changes in KCCQ-12 summary scores and logistic regression to characterize clinically meaningful KCCQ-12 subdomain changes at 30 days.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              There were 350 patients with both enrollment and 30-day KCCQ summary scores available; 166 allocated to usual care and 184 to the intervention arm. Median age was 64 years (interquartile range, 55\u201370), 37% were female participants, 63% were Black, median KCCQ-12 summary score at enrollment was 47 (interquartile range, 33\u201364). Self-care coaching resulted in significantly greater improvement in health status compared with structured usual care (5.4-point greater improvement, 95% CI, 1.12\u20139.68;\n              <jats:italic>P<\/jats:italic>\n              =0.01). Improvements in health status in the intervention arm were driven by improvements within the symptom frequency (adjusted odds ratio, 1.62 [95% CI, 1.01\u20132.59]) and quality of life (adjusted odds ratio, 2.39 [95% CI, 1.46\u20133.90]) subdomains.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In this secondary analysis, patients with acute heart failure who received a tailored, self-care intervention after emergency department discharge had clinically significant improvements in health status at 30 days compared with structured usual care largely due to improvements within the symptom frequency and quality of life subdomains of the KCCQ-12.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02519283.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.121.007956","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T09:05:49Z","timestamp":1632474349000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Improvement in Kansas City Cardiomyopathy Questionnaire Scores After a Self-Care Intervention in Patients With Acute Heart Failure Discharged From the Emergency Department"],"prefix":"10.1161","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct02519283","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3817-1414","authenticated-orcid":true,"given":"William B.","family":"Stubblefield","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine (W.B.S., A.B.S., J.H.H., C.D.M., K.M., W.H.S., S.P.C.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy A.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Biostatistics (C.A.J., D.L.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7176-8346","authenticated-orcid":true,"given":"Dandan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics (C.A.J., D.L.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2893-808X","authenticated-orcid":true,"given":"Alan B.","family":"Storrow","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (W.B.S., A.B.S., J.H.H., C.D.M., K.M., W.H.S., S.P.C.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Informatics, University of Missouri, Kansas City and Saint Luke\u2019s Mid America Heart Institute, MO (J.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3444-2811","authenticated-orcid":true,"given":"Peter S.","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (P.S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7306-5620","authenticated-orcid":true,"given":"Phillip D.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI (P.D.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Medicine (J.B.), University of Mississippi Medical Center, Jackson."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Marie","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Thomas Jefferson University Hospital (A.M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Char","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Internal Medicine, Washington University, Seattle (D.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah B.","family":"Diercks","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, UT Southwestern Medical Center, Dallas, TX (D.B.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Fermann","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Cincinnati, OH (G.J.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin H.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (W.B.S., A.B.S., J.H.H., C.D.M., K.M., W.H.S., S.P.C.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN (J.H.H., S.P.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Hiestand","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC (B.C.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Hogan","sequence":"additional","affiliation":[{"name":"Division of Trauma\/Critical Care, Departments of Emergency Medicine and Surgery, Virginia Commonwealth University Medical Center, Richmond (C.J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosef","family":"Khan","sequence":"additional","affiliation":[{"name":"Health Informatics and Analytics, Centers for Health Metrics and Evaluation, American Heart Association (Y.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangil","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa Carver College of Medicine (S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnn M.","family":"Lindenfeld","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease (J.M.L.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace D.","family":"McNaughton","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (W.B.S., A.B.S., J.H.H., C.D.M., K.M., W.H.S., S.P.C.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (W.B.S., A.B.S., J.H.H., C.D.M., K.M., W.H.S., S.P.C.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Frank","family":"Peacock","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Baylor College of Medicine, Houston, TX (W.F.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon W.","family":"Schrock","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH (J.W.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9300-3045","authenticated-orcid":true,"given":"Wesley H.","family":"Self","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (W.B.S., A.B.S., J.H.H., C.D.M., K.M., W.H.S., S.P.C.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4694-6152","authenticated-orcid":true,"given":"Adam J.","family":"Singer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Stony Brook University, NY (A.J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Sterling","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (S.A.S.), University of Mississippi Medical Center, Jackson."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean P.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine (W.B.S., A.B.S., J.H.H., C.D.M., K.M., W.H.S., S.P.C.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN (J.H.H., S.P.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.019"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.01.006"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2013.05.002"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2005.01.012"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2002.3255"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.747568"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182949a2e"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.5763"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.115.001958"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(00)00531-3"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2013.11.010"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.12.010"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.07.010"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.09.027"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.116.003581"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.042929"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044138"},{"key":"e_1_3_6_22_2","volume-title":"R: A language and environment for statistical computing [computer program]. Version 3.5.2","year":"2017","unstructured":"R: A language and environment for statistical computing [computer program]. Version 3.5.2. R Foundation for Statistical Computing; 2017."},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.542"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-6-43"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2010.01.016"},{"key":"e_1_3_6_26_2","first-page":"CD007228","article-title":"Structured telephone support or non-invasive telemonitoring for patients with heart failure.","author":"Inglis SC","year":"2015","unstructured":"Inglis, SC, Clark, RA, Dierckx, R, Prieto-Merino, D, Cleland, JG. Structured telephone support or non-invasive telemonitoring for patients with heart failure. Cochrane Database Syst Rev. 2015:CD007228.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018006"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000151811.53450.B8"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(01)01699-0"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.001799"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2946"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872620934318"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872620930889"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.006168"}],"updated-by":[{"DOI":"10.1161\/hcq.0000000000000104","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000}}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.121.007956","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T03:40:12Z","timestamp":1715571612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.121.007956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.121.007956"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.121.007956","relation":{"correction":[{"id-type":"doi","id":"10.1161\/HCQ.0000000000000104","asserted-by":"object"}]},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10]]},"assertion":[{"value":"2021-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}