Teach-Back Discharge Education to Improve Self-Care and Reduce 30-Day Readmissions in Heart Failure Patients

February 23, 2026 updated by: Sara Bierschenk, Nova Southeastern University

Impact of Discharge Teach-Back Education on Heart Failure Patients' Knowledge/Self-Care Behaviors and 30-Day Readmissions

This study aimed to improve how patients with heart failure understand and manage their condition after leaving the hospital. Many heart failure patients are readmitted within 30 days due to confusion about their discharge instructions and difficulty following self-care routines. The study tested whether a structured discharge education session using the "teach-back" method-where patients repeated instructions in their own words-could help improve their knowledge and self-care behaviors. The goal was to reduce hospital readmissions and help patients feel more confident managing their heart failure at home.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Heart failure is a chronic and progressive condition affecting millions of adults in the United States. Despite advances in treatment, nearly one in four patients are readmitted to the hospital within 30 days of discharge, often due to poor understanding of discharge instructions and inadequate self-care. These readmissions contribute to worse health outcomes and increased healthcare costs.

This study evaluated the effectiveness of a structured discharge education intervention using the teach-back method. The teach-back method is a communication technique in which patients are asked to repeat discharge instructions in their own words. This approach helps confirm understanding, reinforce learning, and promote active engagement in self-care.

The study used a quasi-experimental, pre-test/post-test design to assess changes in patients' knowledge and self-care behaviors before and after the intervention. Participants were adults hospitalized with systolic heart failure (LVEF ≤ 40%) who meet specific clinical criteria. Each participant received a 30-minute individualized education session at discharge, covering key self-care topics such as medication adherence, symptom monitoring, fluid restriction, and dietary modifications. Printed educational materials from the American Heart Association were also provided.

To measure outcomes, participants completed the European Heart Failure Self-care Behavior Scale (EHFScB-9) before and after the intervention. Thirty-day readmission data was collected through a retrospective review of hospital records. The study aimed to determine whether teach-back education improved self-care behaviors and reduced 30-day readmission rates.

This project was reviewed and exempted by the Nova Southeastern University Institutional Review Board under Exempt Category 2. It aligned with national goals to improve patient education, reduce preventable readmissions, and enhance the quality of care for individuals with heart failure.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
57

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Florida
      • Atlantis, Florida, United States, 33462
        • HCA Florida JFK Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18 years and older
  • Diagnosed with systolic heart failure with a left ventricular ejection fraction (LVEF) ≤ 40%
  • Classified as New York Heart Association (NYHA) Class II, III, or IV
  • Categorized as American College of Cardiology/American Heart Association (ACC/AHA) Stage C or D
  • Currently hospitalized at the project site
  • Able to read and understand English at an 8th grade reading level
  • Have access to a smartphone or tablet capable of scanning QR codes and connecting to the internet
  • Provide voluntary informed consent via the REDCap platform

Exclusion Criteria:

  • Cognitive impairment
  • Non-English speaking
  • Unwilling to participate

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Teach-Back Education Intervention
Participants in this arm received a structured discharge education session using the teach-back method. The session was delivered in person at hospital discharge and covered key heart failure self-care behaviors, including medication adherence, symptom monitoring, fluid restriction, and dietary modifications. Participants were asked to restate instructions in their own words to confirm understanding. Printed educational materials from the American Heart Association were also provided.
Behavioral: Teach-Back Discharge Education
A structured, 30-minute discharge education session delivered in person using the teach-back method. Participants are asked to restate instructions in their own words to confirm understanding. The session covers key heart failure self-care behaviors including medication adherence, symptom monitoring, fluid restriction, and dietary modifications. Printed educational materials from the American Heart Association are also provided.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Heart Failure Self-Care Behaviors (EHFScB-9 Total Score)
Time Frame: Baseline (pre-intervention) and immediately post-intervention on the same day, up to 35 minutes after the start of the education session.
The 9-item European Heart Failure Self-Care Behavior Scale (EHFScB-9) was used to assess self-care behaviors. Each item is scored on a 5-point Likert scale ranging from 1 ("completely agree") to 5 ("do not agree at all"), producing a total score range of 9 to 45. The outcome represents the change in total EHFScB-9 score from baseline (pre-intervention) to immediately post-intervention following the discharge education session. Lower total scores indicate better self-care performance (more consistent adherence to recommended behaviors), while higher total scores indicate poorer self-care performance (less consistent adherence).
Baseline (pre-intervention) and immediately post-intervention on the same day, up to 35 minutes after the start of the education session.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Number of Participants With 30-Day Heart Failure Readmission
Time Frame: Assessed during the 30-day period following hospital discharge.
Readmission status was determined from hospital records and participants were classified as readmitted (Yes) or not readmitted (No) within 30 days of discharge. Data are displayed as counts in the results table.
Assessed during the 30-day period following hospital discharge.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Nova Southeastern University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Virginia Waters, Ph.D., MSN, MBA, RN, CNE-BC, Nova Southeastern University, Ron and Kathy Assaf College of Nursing

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 11, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 11, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 10, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 29, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 10, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 12, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
February 25, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 23, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2025-398

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared for this study. The data collected will be used solely for the purposes of evaluating the effectiveness of the discharge teach-back education intervention on heart failure self-care behaviors and 30-day readmissions. All data will be stored securely and managed in compliance with HIPAA and IRB regulations. Due to the sensitive nature of health information and the limited scope of the study, there is no plan to make IPD publicly available.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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