Evaluation of Satisfaction and Self-Efficacy of Veteran Patients with Heart Failure in a Group Clinic Setting

Abstract

Objectives: To evaluate the group clinic patients’ visit satisfaction and self-efficacy assessments at baseline and six months after the implementation of the heart failure group clinic. Additional outcomes of interest included health service utilization and medication management. Methods: This study utilized a pre-experimental design to compare patients’ clinic visit satisfaction and self-efficacy assessments at baseline and six months. Demographic variables, diagnoses, vitals, health service utilization and medication management data were obtained retrospectively from the computerized patient record system (CPRS). Results: Eleven patients met the inclusion criteria, agreed to participate and completed the informed consent. Mean age was 64.1 years (± 11.28); 100% were male; 45.5% were white, not of Hispanic origin. Health service utilization could not be compared using the planned analysis because of the limited data available for this outcome. Medication management trends included titrating angiotensin-converting enzyme inhibitors (n=1), titrating beta-blockers (n=6), and converting from non-preferred HF medications to ACC/AHA guideline recommended agents (n=3). The mean self-efficacy score increased at follow-up when compared to baseline data (7.4 ± 1.7 versus 6.4 ± 2.7, respectively) with no statistical significance shown between the two groups (p=0.12). Additionally, the mean patient satisfaction score increased at follow-up when compared to the baseline scores (74.5 ± 12.3 versus 71.0 ± 15.1 respectively); however, data analysis revealed no statistical significance (p=0.50). Conclusions: Our study demonstrated trends suggesting improved patient satisfaction and improved self-efficacy with a group clinic model in veteran patients with heart failure. Group clinic settings have the potential to optimize HF medication management in the setting of enormous demand for VA healthcare services and limited financial resources.