Implications of a Self-Care Management Tool on Cardiovascular Events in Heart Failure Patients Within Six Months in a Regional City Hospital of Japan.

Background Patients with heart failure (HF) often face the need to maintain stable symptoms after discharge. Self-care management, including symptom monitoring, is recommended; however, because of factors such as population aging, these self-care behaviors are difficult to maintain for some patients, and the re-hospitalization rate remains high in Japanese registries. Objective In this retrospective cohort study, we aimed to verify whether the use of a self-care management tool among hospitalized patients with HF in a regional city hospital contributes to the reduction of cardiovascular events within a period of six months. Methods We retrospectively analyzed 117 patients hospitalized and treated for HF in Japan between December 2020 and November 2022. Patients admitted by November 2021 were assigned to the non-intervention group, while those admitted after this date and eligible to use the tool were assigned to the intervention group. The incidence of readmission owing to cardiovascular events within six months after discharge was analyzed. Results The Gray test, with unexpected readmissions and deaths due to causes other than cardiovascular events as competing risks, indicated that the intervention of using the self-care management tool reduced cardiovascular events (p=0.045). Even after adjusting for the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) score, the logarithm of B-type natriuretic peptide, and the use of sodium-glucose cotransporter 2 inhibitors, the effect of intervention with the self-care management tool remained significant (hazard ratio: 0.33; 95% confidence interval: 0.15-0.74, p<0.01). Conclusions The use of a self-care management tool for patients with HF was associated with a reduction in cardiovascular events.