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Int J Nurs Stud. 2014 Sep;51(9):1207-13. doi: 10.1016/j.ijnurstu.2014.01.010. Epub 2014 Jan 22.

Nurse facilitated Self-management support for people with heart failure and their family carers (SEMAPHFOR): a randomised controlled trial.

Author information

  • 1York Trials Unit, Department of Health Sciences, University of York, UK. Electronic address:
  • 2British Heart Foundation Care and Education Research Group, Department of Health Sciences, University of York, UK.
  • 3Kleijnen Systematic Reviews, Escrick Business Park, York, UK.
  • 4Centre for Health Economics, University of York, UK.



To compare the clinical effectiveness of a newly developed cognitive behavioural self-management manual delivered by specialist heart failure nurses or the same programme followed by the patient on their own, in terms of readmissions/admissions to hospital for any reason within a 12 month period, patient health related quality of life, self-management and carer quality of life.


Pragmatic, open parallel group, randomised controlled trial.


Open access heart failure diagnostic clinics and primary care.


260 patients with a definitive diagnosis of symptomatic heart failure (LVSD) as defined by ECHO, clinical diagnosis or coronary angiography were eligible for the study.


A newly developed nurse facilitated, cognitive behavioural self-management programme was developed and was delivered either by a heart failure nurse or by the patient on their own.


Patient admission/readmission to hospital for any reason within a 12 month period following randomisation. Secondary outcomes were: participant health related quality of life as measured by the Minnesota Living with Heart Failure questionnaire, the Hospital, Anxiety and Depression Scale, the European self-care form.


There was no evidence of a difference between the groups in whether or not a patient was re-admitted to hospital during the 12 month follow-up period (p=0.66). There was no evidence of a difference between the treatment groups in the mean MLHF scores over time (p=0.768), the European self-care questionnaire (p=0.340) or the mean HAD anxiety score (p=0.786). However, when adjusted for baseline scores the self-management group had a statistically significant higher HADS depression score at 12 months (p=0.003).


There was no evidence of a difference in admissions/readmission to hospital between patients who undertook a brief heart failure self-management programme facilitated by a specialist heart failure nurse and those also receiving care from a specialist nurse who followed the programme on their own.


This trial is registered as ISRCTN84692046.

Copyright © 2014 Elsevier Ltd. All rights reserved.


Cognitive behavioural self-management programme; Heart failure; Randomised controlled trial

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