Evidence map›Paper›PMID 26578668›Full record

Trial reportCirculation. Heart failure2015

Psychosocial Factors, Exercise Adherence, and Outcomes in Heart Failure Patients: Insights From Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION).

Lauren B Cooper, Robert J Mentz, Jie-Lena Sun, Phillip J Schulte, Jerome L Fleg, Lawton S Cooper, Ileana L Piña, Eric S Leifer, William E Kraus, David J Whellan and 2 more

Erratum issued 3 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Heart failure, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00047437 phase3completednot on this map

Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION)

TypeinterventionalSponsorDuke UniversityRan2003 to 2008Enrolled2,331ConditionsCardiovascular Diseases, Heart Diseases, Heart Failure, CongestiveArmsSupervised Exercise Training Program
NCT03615469 naterminatednot on this mapstarted 2018, after this paper: background citation

Building Strength Through Rehabilitation for Heart Failure Patients

TypeinterventionalSponsorIndiana UniversityRan2018 to 2020Enrolled15ConditionsHeart FailureArmsTranscutaneous electrical stimulation, Neuromuscular electrical stimulation
NCT06298825 unknown statusnot on this mapstarted 2024, after this paper: background citation

Effect of Sarcopenia on Prognosis of Patients With Acute Decompensated Heart Failure: a Prospective, Multi-center, Observational Cohort Study

TypeobservationalSponsorGuangdong Provincial People's HospitalRan2024 to 2026Enrolled500ConditionsAcute Decompensated Heart Failure
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Interventions to promote patient utilisation of cardiac rehabilitation.The Cochrane database of systematic reviews · 2019
    Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Article
  9. Article
  10. Observational
  11. Article
  12. Monitoring the Effects of Cardiac Rehabilitation Programs in Heart Failure Patients: The Role of Biomarkers.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025
    Review
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Demographic, Clinical, and Psychosocial Predictors of Exercise Adherence: The STRRIDE Trials.Translational journal of the American College of Sports Medicine · 2023
    Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Lauren B CooperFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.). lauren.b.cooper@duke.edu.
Robert J MentzFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Jie-Lena SunFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Phillip J SchulteFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Jerome L FlegFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Lawton S CooperFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Ileana L PiñaFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Eric S LeiferFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
William E KrausFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
David J WhellanFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Steven J KeteyianFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).
Christopher M O'ConnorFrom the Duke Clinical Research Institute (L.B.C., R.J.M., J.-L.S., P.J.S., C.M.O'C.), and Department of Medicine (L.B.C., R.J.M., W.E.K., C.M.O'C.), Duke University School of Medicine, Durham, NC; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.L.F., L.S.C., E.S.L.); Division of Cardiology, Albert Einstein College of Medicine, Bronx, NY (I.L.P.); Division of Cardiology, Jefferson Medical College, Philadelphia, PA (D.J.W.); and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI (S.J.K.).

Funding

Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
NHLBI NIH HHS T32 HL069749NHLBI NIH HHS T32HL069749-11A1
6 · The paper itself

Abstract

backgroundPsychosocial factors may influence adherence with exercise training for heart failure (HF) patients. We aimed to describe the association between social support and barriers to participation with exercise adherence and clinical outcomes. METHODS AND

resultsOf patients enrolled in Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION), 2279 (97.8%) completed surveys to assess social support and barriers to exercise, resulting in the perceived social support score (PSSS) and barriers to exercise score (BTES). Higher PSSS indicated higher levels of social support, whereas higher BTES indicated more barriers to exercise. Exercise time at 3 and 12 months correlated with PSSS (r= 0.09 and r= 0.13, respectively) and BTES (r=-0.11 and r=-0.12, respectively), with higher exercise time associated with higher PSSS and lower BTES (All P<0.005). For cardiovascular death or HF hospitalization, there was a significant interaction between the randomization group and BTES (P=0.035), which corresponded to a borderline association between increasing BTES and cardiovascular death or HF hospitalization in the exercise group (hazard ratio 1.25, 95% confidence interval 0.99, 1.59), but no association in the usual care group (hazard ratio 0.83, 95% confidence interval 0.66, 1.06).

conclusionsPoor social support and high barriers to exercise were associated with lower exercise time. PSSS did not impact the effect of exercise training on outcomes. However, for cardiovascular death or HF hospitalization, exercise training had a greater impact on patients with lower BTES. Given that exercise training improves outcomes in HF patients, assessment of perceived barriers may facilitate individualized approaches to implement exercise training therapy in clinical practice. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00047437.

Indexed as

ExercisePatient ComplianceAgedExercise ToleranceFemaleHeart FailureHospitalizationHumansMaleMiddle AgedQuality of LifeSocial SupportStroke VolumeTreatment Outcomeexerciseexercise therapyheart failurepatientssocial support

Identifiers

PMID26578668
PMCPMC4804461

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.