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Developing an instrument to measure heart failure disease management program intensity and complexity

Barbara Riegel1, Christopher S Lee, Julie Sochalski

  • 1University of Pennsylvania, Philadelphia, 19104-4217, USA. briegel@nursing.upenn.edu <briegel@nursing.upenn.edu>

Circulation. Cardiovascular Quality and Outcomes
|May 21, 2010
PubMed

Insights

A new scoring instrument helps standardize the description of heart failure (HF) disease management programs. The Heart Failure Disease Management Scoring Instrument (HF-DMSI) assesses program intensity and complexity, improving comparisons.

Area of Science:

  • Cardiology
  • Health Services Research
  • Medical Informatics

Background:

  • Comparing heart failure (HF) disease management programs is challenging due to variability in intensity and complexity.
  • A standardized method is needed to objectively describe these programs.

Purpose of the Study:

  • To develop an instrument for describing the intensity and complexity of HF disease management programs.

Main Methods:

  • Adapted criteria from the American Heart Association (AHA) taxonomy of disease management.
  • Developed the Heart Failure Disease Management Scoring Instrument (HF-DMSI) covering 6 domains.
  • Used hierarchical scoring and an ordinal system to rate intensity and complexity.
  • Assessed content validity against the AHA taxonomy and inter-rater reliability.

Main Results:

  • The HF-DMSI incorporates key domains: recipient, intervention content, delivery personnel, communication method, intensity/complexity, and environment.
  • Inter-rater reliability was high (ICC=0.918) after refinement.
  • Delivery personnel and communication methods showed the most variability among programs.

Conclusions:

  • The HF-DMSI is a valuable tool for characterizing the intensity and complexity of HF disease management programs.
  • This instrument facilitates more consistent comparisons of different HF management strategies.
Abstract

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