105 Implementation of patients reaction is better than implementation of knowledge in Heart failure patients.

Heart failure remains a disease with poor prognosis despite the therapeutic advances of recent decades. Nearly a third of hospital admissions are due to errors in dietetics follow up or therapeutic monitoring. Therapeutic education of patients with heart failure is growing fast in France. For the “Haute autorité de santé” (HAS), evaluation of education programs is an essential element in the same way that the educational diagnosis and interactivity. We wanted to determine what the assessment could predict the onset of the test combined death and hospitalization for heart failure. We included 398 patients with systolic heart failure who received a therapeutic education between 2003 and 2008. The program involved an educational diagnosis individual training sessions with the disease, sessions Implementation situation, self-physical and dietary. During this educational process, patients filled a questionnaire initial knowledge (Q1) and a questionnaire at the end of training (Q2) and one year of it (Q3). They also fulfilled a clinical case assessment and post training within one year. The average age of patients was 65 (± 4), LVEF of 34 (± 4), the average BNP of 235 (± 346). There is no correlation between the scores of knowledge questionnaires and questionnaires of clinical cases. In ROC curve there is no cut off for predicting the occurrence of a major event. In survival curve there is no difference between patients having a response greater than the median at questionnaire1, 2 or 3. however patients with a clinical performance at post training clinical cases above the median had an event-free survival significantly better than those with a response below the median (p <0001). Conclusion: The evaluation of the reactions of patients with clinical cases is greater than the simple evaluation of the knowledge of patients in terms of predicting survival without hospitalization for heart failure. [Copyright &y& Elsevier]