Health School effectiveness in patients with chronic heart failure: gender differences

Aim. To compare the effectiveness of Health School (HS) initiative in male and female patients with chronic heart failure (CHF). Material and methods. The study included 239 CHF patients: 118 women and 119 men. For both genders, the patients were randomised into intervention groups, studying at HS (58 women and 59 men), and control groups, not receiving any educational intervention (60 women, 60 men). The follow-up period lasted for one year. The criteria of HS effectiveness included relative and absolute parameters of hospitalisation due to decompensated CHF; seeking for urgent medical care due to CHF decompensation; unplanned visits to the doctor; clinical CHF status dynamics by the scale modified by V.Yu. Mareev (2000); 6-minute walk test results; electrocardiography (ECG) and echocardiography (EchoCG) results. Results. HS effectiveness was significantly different in female and male intervention vs. control groups. In women, being educated at HS did not affect the incidence of hospitalizations and unplanned visits to the doctor due to decompensated CHF, while in men, the same parameters were substantially lower in those from the intervention group. Similarly, clinical CHF status, 6-minute walk test results, and ECG repolarization parameters were not changed by HS participation in women, but were improved in men attending HS. At the same time, the incidence of seeking for urgent medical help was significantly lower in both female and male HS groups. Conclusion. Planning the strategy of secondary CHF prevention should take into account the gender differences; otherwise, the effectiveness could be inadequate in female patients.