, Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). The CONSENSUS Trial Study Group, N Engl J Med, vol.316, issue.23, pp.1429-1464, 1987.

, Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators, N Engl J Med, vol.325, issue.5, pp.293-302, 1991.

R. Garg and S. Yusuf, Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials, JAMA: The Journal of the American Medical Association, vol.273, issue.18, pp.1450-1456, 1995.
DOI : 10.1001/jama.273.18.1450

M. Packer, A. Coats, M. Fowler, H. Katus, H. Krum et al., Effect of Carvedilol on Survival in Severe Chronic Heart Failure, New England Journal of Medicine, vol.344, issue.22, pp.1651-1659, 2001.
DOI : 10.1056/NEJM200105313442201

, Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet Lond Engl, Jun, vol.12353, issue.9169, pp.2001-2008, 1999.

, The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial, Lancet Lond Engl, vol.353, issue.9146, pp.9-13, 1999.

M. Flather, M. Shibata, A. Coats, V. Veldhuisen, D. Parkhomenko et al., Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS), European Heart Journal, vol.26, issue.3, pp.215-240, 2005.
DOI : 10.1016/S0002-8703(03)00315-6

B. Pitt, F. Zannad, W. Remme, R. Cody, A. Castaigne et al., The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure, New England Journal of Medicine, vol.341, issue.10, pp.709-726, 1999.
DOI : 10.1056/NEJM199909023411001

B. Pitt, W. Remme, F. Zannad, J. Neaton, F. Martinez et al., Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction, New England Journal of Medicine, vol.348, issue.14, pp.1309-1330, 2003.
DOI : 10.1056/NEJMoa030207

F. Zannad, J. Mcmurray, H. Drexler, H. Krum, D. Van-veldhuisen et al., Rationale and design of the Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure (EMPHASIS-HF) Eur J Heart Fail, pp.617-639, 2010.

M. Komajda, P. Lapuerta, N. Hermans, J. Gonzalez-juanatey, D. Van-veldhuisen et al., Adherence to guidelines is a predictor of outcome in chronic heart failure: the MAHLER survey, European Heart Journal, vol.26, issue.16, pp.1653-1662, 2005.
DOI : 10.1016/j.ahj.2004.03.004

S. Yusuf, M. Pfeffer, K. Swedberg, C. Granger, P. Held et al., Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial, The Lancet, vol.362, issue.9386, pp.777-81, 2003.
DOI : 10.1016/S0140-6736(03)14285-7

J. Cleland, M. Tendera, J. Adamus, N. Freemantle, C. Gray et al., Perindopril for elderly people with chronic heart failure: the PEP-CHF study, European Journal of Heart Failure, vol.92, issue.Suppl 19, pp.211-218, 1999.
DOI : 10.1007/978-1-4899-3115-3

A. Cherubini, J. Oristrell, X. Pla, C. Ruggiero, R. Ferretti et al., The Persistent Exclusion of Older Patients From Ongoing Clinical Trials Regarding Heart Failure, Archives of Internal Medicine, vol.171, issue.6, pp.550-556, 2011.
DOI : 10.1001/archinternmed.2011.31

A. Heiat, C. Gross, and H. Krumholz, Representation of the Elderly, Women, and Minorities in Heart Failure Clinical Trials, Archives of Internal Medicine, vol.162, issue.15, pp.1682-1690, 2002.
DOI : 10.1001/archinte.162.15.1682

F. Peters-klimm, T. Müller-tasch, D. Schellberg, A. Remppis, A. Barth et al., Guideline adherence for pharmacotherapy of chronic systolic heart failure in general practice: a closer look on evidence-based therapy, Clinical Research in Cardiology, vol.40, issue.3, 2008.
DOI : 10.1007/s00392-007-0617-6

J. Cleland, A. Cohen-solal, J. Aguilar, R. Dietz, J. Eastaugh et al., Management of heart failure in primary care (the IMPROVEMENT of Heart Failure Programme): an international survey, The Lancet, vol.360, issue.9346, pp.1631-1640, 2002.
DOI : 10.1016/S0140-6736(02)11601-1

M. Hirt, A. Muttardi, T. Helms, H. Van-den-bussche, and T. Eschenhagen, General practitioners' adherence to chronic heart failure guidelines regarding medication: the GP-HF study, Clinical Research in Cardiology, vol.38, issue.4, 2009.
DOI : 10.1002/clc.22375

F. Rutten, D. Grobbee, and A. Hoes, Differences between general practitioners and cardiologists in diagnosis and management of heart failure: a survey in every-day practice, European Journal of Heart Failure, vol.158, issue.Suppl I, pp.337-381, 2003.
DOI : 10.1001/archinte.158.10.1108

J. Cleland, K. Swedberg, F. Follath, M. Komajda, A. Cohen-solal et al., The EuroHeart Failure survey programme???a survey on the quality of care among patients with heart failure in Europe Part 1: patient characteristics and diagnosis, European Heart Journal, vol.24, issue.5, 2003.
DOI : 10.1016/S0195-668X(02)00823-0

M. Schou, F. Gustafsson, L. Videbaek, C. Tuxen, N. Keller et al., Extended heart failure clinic follow-up in low-risk patients: a randomized clinical trial (NorthStar), European Heart Journal, vol.12, issue.6, pp.432-474, 2013.
DOI : 10.1093/eurjhf/hfq154

URL : https://academic.oup.com/eurheartj/article-pdf/34/6/432/17897302/ehs235.pdf

M. Luttik, T. Jaarsma, P. Van-geel, M. Brons, H. Hillege et al., Long-term follow-up in optimally treated and stable heart failure patients: primary care vs. heart failure clinic. Results of the COACH-2 study, European Journal of Heart Failure, vol.93, issue.11, pp.1241-1249, 2014.
DOI : 10.1136/hrt.2006.095810

URL : http://onlinelibrary.wiley.com/doi/10.1002/ejhf.173/pdf

M. Valk, A. Hoes, A. Mosterd, M. Landman, B. Broekhuizen et al., Rationale, design and baseline results of the Treatment Optimisation in Primary care of Heart failure in the Utrecht region (TOPHU) study: a cluster randomised controlled trial, BMC Family Practice, vol.110, issue.5, p.130, 2015.
DOI : 10.1016/S0002-9343(00)00743-9

A. Samman-tahhan, M. Vaduganathan, A. Kelkar, V. Georgiopoulou, A. Kalogeropoulos et al., Trends in Heart Failure Clinical Trials From 2001???2012, Journal of Cardiac Failure, vol.22, issue.3, 2015.
DOI : 10.1016/j.cardfail.2015.06.014

G. Güder, J. Bauersachs, S. Frantz, D. Weismann, B. Allolio et al., Complementary and incremental mortality risk prediction by cortisol and aldosterone in chronic heart failure. Circulation, pp.1754-61, 2007.

B. Borlaug, V. Melenovsky, S. Russell, K. Kessler, K. Pacak et al., Impaired chronotropic and vasodilator reserves limit exercise capacity in patients with heart failure and a preserved ejection fraction. Circulation, pp.2138-2185, 2006.
DOI : 10.1161/circulationaha.106.632745

URL : http://circ.ahajournals.org/content/circulationaha/114/20/2138.full.pdf

S. Kubo, T. Rector, A. Bank, R. Williams, and S. Heifetz, Endothelium-dependent vasodilation is attenuated in patients with heart failure. Circulation, pp.1589-96, 1991.
DOI : 10.1161/01.cir.84.4.1589

URL : http://circ.ahajournals.org/content/84/4/1589.full.pdf

C. Lam, V. Roger, R. Rodeheffer, B. Borlaug, F. Enders et al., Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction, Journal of the American College of Cardiology, vol.53, issue.13, pp.1119-1145, 2009.
DOI : 10.1016/j.jacc.2008.11.051

D. Keulenaer, G. Brutsaert, and D. , Systolic and diastolic heart failure are overlapping phenotypes within the heart failure spectrum. Circulation, pp.1996-2004, 2005.

M. Komajda and C. Lam, Heart failure with preserved ejection fraction: a clinical dilemma, European Heart Journal, vol.106, issue.1, pp.1022-1054, 2014.
DOI : 10.1007/s00395-010-0139-7

S. Solomon, N. Anavekar, H. Skali, J. Mcmurray, K. Swedberg et al., Influence of ejection fraction on cardiovascular outcomes in a broad spectrum of heart failure patients. Circulation, pp.3738-3782, 2005.

H. Fukuta and W. Little, Contribution of systolic and diastolic abnormalities to heart failure with a normal and a reduced ejection fraction. Prog Cardiovasc Dis, Feb, vol.49, issue.4, pp.229-269, 2007.

J. Wang, D. Khoury, Y. Yue, G. Torre-amione, and S. Nagueh, Preserved left ventricular twist and circumferential deformation, but depressed longitudinal and radial deformation in patients with diastolic heart failure, European Heart Journal, vol.29, issue.10, pp.1283-1292, 2008.
DOI : 10.1093/eurheartj/ehn141

URL : https://academic.oup.com/eurheartj/article-pdf/29/10/1283/1261768/ehn141.pdf

B. Borlaug, C. Lam, V. Roger, R. Rodeheffer, and M. Redfield, Contractility and Ventricular Systolic Stiffening in Hypertensive Heart Disease, Journal of the American College of Cardiology, vol.54, issue.5, pp.410-418, 2009.
DOI : 10.1016/j.jacc.2009.05.013

URL : https://doi.org/10.1016/j.jacc.2009.05.013

Y. Tan, F. Wenzelburger, E. Lee, G. Heatlie, F. Leyva et al., The Pathophysiology of Heart Failure With Normal Ejection Fraction, Journal of the American College of Cardiology, vol.54, issue.1, pp.36-46, 2009.
DOI : 10.1016/j.jacc.2009.03.037

M. Drazner, The transition from hypertrophy to failure: how certain are we? Circulation, 2005.
DOI : 10.1161/circulationaha.105.558734

URL : http://circ.ahajournals.org/content/circulationaha/112/7/936.full.pdf

, Aug, vol.16112, issue.7, pp.936-944

M. Packer, Can Brain Natriuretic Peptide Be Used to Guide the Management of Patients With Heart Failure and a Preserved Ejection Fraction?: The Wrong Way to Identify New Treatments for a Nonexistent Disease, Circulation: Heart Failure, vol.4, issue.5, pp.538-578, 2011.
DOI : 10.1161/CIRCHEARTFAILURE.111.963710

R. Campbell, P. Jhund, D. Castagno, N. Hawkins, M. Petrie et al., What Have We Learned About Patients With Heart Failure and Preserved Ejection Fraction From DIG-PEF, CHARM-Preserved, and I-PRESERVE?, Journal of the American College of Cardiology, vol.60, issue.23, pp.2349-56, 2012.
DOI : 10.1016/j.jacc.2012.04.064

A. Takeda, S. Taylor, R. Taylor, F. Khan, H. Krum et al., Clinical service organisation for heart failure, Cochrane Database of Systematic Reviews, vol.38, issue.2, p.2752, 2012.
DOI : 10.1002/14651858.CD002752.pub2

H. Drewes, L. Steuten, L. Lemmens, C. Baan, H. Boshuizen et al., The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes, Health Services Research, vol.27, issue.5, pp.1926-59, 2012.
DOI : 10.7326/0003-4819-141-8-200410190-00008

I. Bos-touwen, N. Jonkman, H. Westland, M. Schuurmans, F. Rutten et al., Tailoring of self-management interventions in patients with heart failure. Curr Heart Fail Rep, 2015.
DOI : 10.1007/s11897-015-0259-3

URL : https://link.springer.com/content/pdf/10.1007%2Fs11897-015-0259-3.pdf

T. Jaarsma, R. Halfens, F. Tan, H. Abu-saad, K. Dracup et al., Self-care and quality of life in patients with advanced heart failure: The effect of a supportive educational intervention, Heart & Lung: The Journal of Acute and Critical Care, vol.29, issue.5, pp.319-349, 2000.
DOI : 10.1067/mhl.2000.108323

S. Stewart, J. Marley, and J. Horowitz, Effects of a multidisciplinary, home-based intervention on planned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study, The Lancet, vol.354, issue.9184, pp.1077-83, 1999.
DOI : 10.1016/S0140-6736(99)03428-5

C. Cline, B. Israelsson, R. Willenheimer, K. Broms, and L. Erhardt, Cost effective management programme for heart failure reduces hospitalisation. Heart Br Card Soc, pp.442-448, 1998.
DOI : 10.1136/hrt.80.5.442

URL : http://heart.bmj.com/content/heartjnl/80/5/442.full.pdf

K. Mcdonald, M. Ledwidge, J. Cahill, P. Quigley, B. Maurer et al., Heart failure management: Multidisciplinary care has intrinsic benefit above the optimization of medical care, Journal of Cardiac Failure, vol.8, issue.3, pp.142-150, 2002.
DOI : 10.1054/jcaf.2002.124340

K. Wyrwich, W. Tierney, A. Babu, K. Kroenke, and F. Wolinsky, A Comparison of Clinically Important Differences in Health-Related Quality of Life for Patients with Chronic Lung Disease, Asthma, or Heart Disease, Health Services Research, vol.11, issue.(1, pp.577-91, 2005.
DOI : 10.1177/016327879802100205

B. Agvall, U. Alehagen, and U. Dahlström, The benefits of using a heart failure management programme in Swedish primary healthcare, European Journal of Heart Failure, vol.16, issue.803-869, pp.228-264, 2013.
DOI : 10.3109/13814788.2010.527938

W. Hopman, C. Berger, L. Joseph, T. Towheed, E. Vandenkerkhof et al., The Natural Progression of Health-Related Quality of Life: Results of a Five-Year Prospective Study of SF-36 Scores in a Normative Population, Quality of Life Research, vol.38, issue.Supplement II, pp.527-563, 2006.
DOI : 10.1002/9780470316696

D. Braunholtz, S. Edwards, and R. Lilford, Are randomized clinical trials good for us (in the short term)? Evidence for a ???trial effect???, Journal of Clinical Epidemiology, vol.54, issue.3, pp.217-241, 2001.
DOI : 10.1016/S0895-4356(00)00305-X

. Accueil-ogdpc-organisme-gestionnaire-du-développement-professionnel and . Continu, Available from: https, 2016.

. Contrôle, Organisme gestionnaire du développement professionnel continu et évaluation du développement professionnel continu des professionnels de santé -Rapport_2013- 126R_controle_OGDPC

A. Saurel, Perception des médecins généralistes après leur participation à un essai contrôlé randomisé d'éducation thérapeutique des patients insuffisants cardiaques: une étude qualitative en Auvergne (Doctoral dissertation), 2013.

L. Garbacz, Y. Juillière, A. F. Jourdain, P. Guyon, G. Coudane et al., Perception of therapeutic patient education in heart failure by healthcare providers, Archives of Cardiovascular Diseases, vol.108, issue.8-9, pp.8-9446, 2015.
DOI : 10.1016/j.acvd.2015.03.008

URL : https://hal.archives-ouvertes.fr/hal-01814825

. Loi, relative à la politique de santé publique Site disponible sur http, 2004.

H. Autorité and D. Santé, Education thérapeutique du patient : Définition, finalités et organisation. Paris : HAS ; Juin, 2007.

H. Autorité and D. Santé, Education thérapeutique du patient: Comment la proposer et la réaliser ? Paris: HAS ; Juin, 2007.

L. Ministère-de and . Santé, Plan 2007-2011 pour l'amélioration de la qualité de vie des personnes atteintes de maladie chronique, 2007.

. Loi, portant réforme de l'hôpital et relative aux patients, à la santé et aux territoires Disponible sur < http, 2009.

, Ministère des affaires sociales et de la santé. Le pacte " territoire-santé " pour lutter contre les déserts médicaux, 2012.

D. Jacquat, Education th??rapeutique du patient, HEGEL - HEpato-GastroEnt??rologie Lib??rale, issue.3
DOI : 10.4267/2042/44373

L. Garbacz, Les problèmes éthiques et juridiques de la prise en charge du patient face à l'émergence de nouvelles pratiques médicales, 2014.

J. Prochaska and C. Diclemente, Stages and processes of self-change of smoking: Toward an integrative model of change., Journal of Consulting and Clinical Psychology, vol.51, issue.3, pp.390-395, 1983.
DOI : 10.1037/0022-006X.51.3.390

C. Lee, N. Tkacs, and B. Riegel, The Influence of Heart Failure Self-care on Health Outcomes, The Journal of Cardiovascular Nursing, vol.24, issue.3, pp.179-87, 2009.
DOI : 10.1097/JCN.0b013e31819b5419

B. Riegel and R. Lepetri, Heart failure disease management models(s) Improving outcome in heart failure an interdisciplinary approach, Maryland: Aspen, pp.267-81, 2001.

H. Krumholz, P. Currie, B. Riegel, C. Phillips, E. Peterson et al., A Taxonomy for Disease Management: A Scientific Statement From the American Heart Association Disease Management Taxonomy Writing Group, Circulation, vol.114, issue.13, pp.1432-1477, 2006.
DOI : 10.1161/CIRCULATIONAHA.106.177322

B. Riegel, T. Jaarsma, and A. Strömberg, A Middle-Range Theory of Self-Care of Chronic Illness, Advances in Nursing Science, vol.35, issue.3, pp.194-204, 2012.
DOI : 10.1097/ANS.0b013e318261b1ba

W. Pagliano, Revue systématique de la littérature sur la qualité méthodologique des essais randomisés en cluster en médecine générale (Doctoral dissertation), 2012.

, Annexe 3

H. Vaillant-roussel, C. Laporte, B. Pereira, D. Rosa, M. Eschalier et al., Impact of patient education on chronic heart failure in primary care (ETIC): a cluster randomised trial, BMC Family Practice, vol.27, issue.1, 2016.
DOI : 10.1016/j.cct.2005.11.003

URL : https://hal.archives-ouvertes.fr/hal-01887015

, Impact of patient education on chronic heart failure in primary care (ETIC): a cluster randomised trial

H. Vaillant-roussel, Catherine Laporte 1,3 , Bruno Pereira 4 , Marion De Rosa 1 , Bénédicte Eschalier 1 , Charles Vorilhon 5 , Romain Eschalier 5 , Gilles Clément 1, Denis Pouchain, vol.1, issue.6 2 18

, Corresponding author: Hélène Vaillant-Roussel

, 78; fax: +33 73 17 81 26; email: helene.vaillant_roussel@udamail.fr; Address: Department of General Practice, Faculty of Medicine of Clermont-Ferrand, 28 Place Henri Dunant

, Bruno Pereira, vol.4

, Bénédicte Eschalier, vol.1

, Charles Vorilhon, vol.5

, Romain Eschalier, vol.5

, Jean-François Chenot, vol.7

, Claude Dubray, vol.2

, Philippe Vorilhon, vol.1

, General Practice Department

H. Dunant,

, Clinical Investigation Center, INSERM CIC 1401

. Npsy-sydo,

H. Dunant,

, Clinical Research and Innovation Department, Biostatistics unit

, 58 Rue Montalembert, Hospital, vol.63000

, Rue Montalembert, vol.58, p.63000

. Clermont-ferrand,

H. Dunant, 63000 Clermont-Ferrand, France List of abbreviations BMI: Body mass index CHF: Chronic heart failure CI: Confidence interval GP: General practitioner HF: Heart failure HFpEF: Heart failure with preserved ejection fraction

. Hfref, Heart failure with reduced ejection fraction ICC: Intra-cluster coefficient NYHA: New York Heart Association MLHFQ: Minnesota Living with Heart Failure Questionnaire SF-36: MOS 36-Item Short Form Health Survey References 1

M. Cowie, D. Wood, A. Coats, S. Thompson, P. Poole-wilson et al.,

, Incidence and aetiology of heart failure; a population-based study, Eur Heart J, vol.20, pp.421-429, 1999.

T. Saudubray, C. Saudubray, C. Viboud, G. Jondeau, A. Valleron et al.,

, Prevalence and management of heart failure in France: national study among general practitioners of the Sentinelles network], Rev Med Interne, vol.26, pp.845-50, 2005.

K. Dickstein, A. Cohen-solal, G. Filippatos, J. Mcmurray, P. Ponikowski et al., ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008???, Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM), pp.2388-442, 2008.
DOI : 10.1016/j.ejheart.2007.04.003

P. Assyag, T. Renaud, A. Cohen-solal, M. Viaud, and H. Krys,

R. Bourgueil, Y. Cohen, and A. , RESICARD: East Paris network for the management of heart failure: absence of effect on mortality and rehospitalization in patients with severe heart failure admitted following severe decompensation, Arch Cardiovasc Dis, vol.102, pp.29-41, 2009.

Y. Juillière, P. Jourdain, J. Roncalli, J. Trochu, E. Gravoueille et al., Therapeutic education for cardiac failure patients: the I-care programme], Arch Mal Coeur Vaiss, vol.98, pp.300-307, 2005.

P. Dendale, D. Keulenaer, G. Troisfontaines, P. Weytjens, C. Mullens et al.,

M. Houbrechts, K. Willekens, and D. Hansen, Effect of a telemonitoring-facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA-HF 1 (TElemonitoring in the MAnagement of Heart Failure) study, European Journal of Heart Failure, vol.14, pp.333-373, 2012.

E. Kasper, G. Gerstenblith, G. Hefter, E. Van-anden, J. Brinker et al.,

S. Forman and S. Gottlieb, A randomized trial of the efficacy of multidisciplinary care in heart failure outpatients at high risk of hospital readmission, J Am Coll Cardiol, vol.39, pp.471-80, 2002.

S. Stewart, M. Carrington, T. Marwick, P. Davidson, P. Macdonald et al.,

H. Newton, P. Reid, C. Chan, Y. Scuffham, and P. , Impact of Home Versus Clinic-Based Management of Chronic Heart Failure: The WHICH? (Which Heart Failure Intervention Is Most Cost-Effective & Consumer Friendly in Reducing Hospital Care) Multicenter, Randomized Trial, J Am Coll Cardiol, vol.60, pp.1239-1287, 2012.

F. Atienza, M. Anguita, N. Martinez-alzamora, J. Osca, S. Ojeda et al.,

F. Vallés, J. De-velasco, . Price-study, and . Group, Multicenter randomized trial of a comprehensive hospital discharge and outpatient heart failure management program, Eur J Heart Fail, vol.6, pp.643-52, 2004.

M. Harrison, G. Browne, J. Roberts, P. Tugwell, A. Gafni et al., Quality of Life of Individuals With Heart Failure, Medical Care, vol.40, issue.4, pp.271-82, 2002.
DOI : 10.1097/00005650-200204000-00003

P. De-la-porte, D. Lok, D. Van-veldhuisen, J. Van-wijngaarden, and J. Cornel,

N. Zuithoff, E. Badings, and A. Hoes, Added value of a physician-and-nurse-directed heart failure clinic: results from the Deventer-Alkmaar heart failure study, Heart, vol.93, pp.819-844, 2007.

F. Peters-klimm, S. Campbell, K. Hermann, C. Kunz, T. Müller-tasch et al., Case management for patients with chronic systolic heart failure in primary care: The HICMan exploratory randomised controlled trial, Trials, vol.13, issue.Spec No, 2010.
DOI : 10.1023/B:QURE.0000015285.08673.42

J. Pérez, E. Rayó, E. Recio, J. Roig, E. Vidal et al., Randomized clinical trial of the effectiveness of a home-based intervention in patients with heart failure: the IC-DOM study, Rev Esp Cardiol, vol.62, pp.400-408, 2009.

H. Vaillant-roussel, C. Laporte, B. Pereira, G. Tanguy, J. Cassagnes et al.,

L. Reste, J. Lebeau, J. Chenot, J. Pouchain, D. Dubray et al., Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial, BMC Fam Pract, vol.15, p.208, 2014.
URL : https://hal.archives-ouvertes.fr/hal-01887031

M. Campbell, D. Elbourne, and D. Altman, CONSORT statement: extension to cluster randomised trials, BMJ, vol.328, issue.7441, pp.702-710, 2004.
DOI : 10.1136/bmj.328.7441.702

A. Leplège, E. Ecosse, A. Verdier, and T. Perneger, The French SF-36 Health Survey, Journal of Clinical Epidemiology, vol.51, issue.11, pp.1013-1036, 1998.
DOI : 10.1016/S0895-4356(98)00093-6

J. Naveiro-rilo, D. Diez-juárez, R. Blanco, A. Rebollo-gutiérrez, and F. ,

A. Martínez and M. Rodríguez-garcía, Validation of the Minnesota living with heart failure questionnaire in primary care, Rev Esp Cardiol, vol.63, pp.1419-1446, 2010.

S. Briançon, A. F. Méjat, E. Guillemin, F. Villemot, J. Mertes et al., Measurement of functional inability and quality of life in cardiac failure. Transcultural adaptation and validation of the Goldman, Minnesota and Duke questionnaires, Arch Mal Coeur Vaiss, vol.90, pp.1577-85, 1997.

X. Girerd, O. Hanon, K. Anagnostopoulos, C. Ciupek, J. Mourad et al., Assessment of antihypertensive compliance using a self-administered questionnaire: development and use in a hypertension clinic], Presse Med, vol.30, pp.1044-1052, 2001.

C. Diclemente and J. Prochaska, Self-change and therapy change of smoking behavior: A comparison of processes of change in cessation and maintenance, Addictive Behaviors, vol.7, issue.2, pp.133-175, 1982.
DOI : 10.1016/0306-4603(82)90038-7

J. Prochaska and C. Diclemente, Stages and processes of self-change of smoking: Toward an integrative model of change., Journal of Consulting and Clinical Psychology, vol.51, issue.3, pp.390-395, 1983.
DOI : 10.1037/0022-006X.51.3.390

G. Adams, M. Gulliford, O. Ukoumunne, S. Eldridge, S. Chinn et al., Patterns of intra-cluster correlation from primary care research to inform study design and analysis, Journal of Clinical Epidemiology, vol.57, issue.8, pp.785-94, 2004.
DOI : 10.1016/j.jclinepi.2003.12.013

J. Cohen and D. Altman, Statistical power analysis for the behavioral sciences. 2 nd ed. Lawrence Erlbaum Statistics notes: Analysing controlled trials with baseline and follow up measurements, BMJ, vol.323, pp.1123-1127, 1988.

A. Cherubini, J. Oristrell, X. Pla, C. Ruggiero, R. Ferretti et al.,

C. Hertogh, V. Lesauskaite, G. Prada, K. Szczerbinska, E. Topinkova et al., The persistent exclusion of older patients from ongoing clinical trials regarding heart failure, Arch Intern Med, vol.171, pp.550-556, 2011.

J. Cleland, A. Cohen-solal, J. Aguilar, R. Dietz, J. Eastaugh et al.,

A. Gavazzi, W. Van-gilst, F. Hobbs, and J. Korewicki,

, IMPROVEMENT of Heart Failure Programme Committees and Investigators. Management of heart failure in primary care (the IMPROVEMENT of Heart Failure Programme): an international survey, Lancet, vol.360, pp.1631-1640, 2002.

A. Heiat, C. Gross, and H. Krumholz, Representation of the Elderly, Women, and Minorities in Heart Failure Clinical Trials, Archives of Internal Medicine, vol.162, issue.15, pp.1682-1690, 2002.
DOI : 10.1001/archinte.162.15.1682

W. Hopman, C. Berger, L. Joseph, T. Towheed, and E. Vandenkerkhof,

J. Ioannidis, G. Brown, J. Hanley, D. Papadimitropoulos, and E. Group, The natural progression of health-related quality of life: results of a five-year prospective study of SF-36 scores in a normative population, Qual Life Res, vol.15, pp.527-563, 2006.

R. Roccaforte, C. Demers, F. Baldassarre, K. Teo, K. Yusuf et al., Effectiveness of comprehensive disease management programmes in improving clinical outcomes in heart failure patients. A metaanalysis Clinical service organisation for heart failure A comparison of clinically important differences in health-related quality of life for patients with chronic lung disease, asthma, or heart disease, Eur J Heart Fail Cochrane Database Syst Rev Health Serv Res, vol.7, issue.40, pp.1133-44577, 2005.

B. Agvall, U. Alehagen, and U. Dahlström, The benefits of using a heart failure management programme in Swedish primary healthcare, European Journal of Heart Failure, vol.16, issue.803-869, pp.228-264, 2013.
DOI : 10.3109/13814788.2010.527938

M. Cancian, A. Battaggia, M. Celebrano, D. Zotti, F. Novelletto et al.,

M. Pellizzari and R. Toffanin, The care for chronic heart failure by general practitioners. Results from a clinical audit in Italy, Eur J Gen Pract, vol.19, pp.3-10, 2013.

S. Köberich, C. Lohrmann, O. Mittag, T. Dassen, R. Ecochard et al., Effects of a hospital-based education programme on self-care behaviour, care dependency and quality of life in patients with heart failure--a randomised controlled trial How do French GPs consider participating in primary care research: the DRIM study Institut national de prévention et d'éducation pour la santé [prevention and health education national institute]. Baromètre santé médecins généralistes Saint-Denis, Baromètres santé, pp.1643-55226, 2009.

J. Adamson, S. Cockayne, S. Puffer, and D. Torgerson, Review of randomised trials using the post-randomised consent (Zelen's) design, Contemporary Clinical Trials, vol.27, issue.4, pp.305-324, 2006.
DOI : 10.1016/j.cct.2005.11.003

, Group practices, n (%) 16 (59.3) 19 (70.4)

, Trainee supervisors * n (%) 19 (70.4) 13 (48.2) Number of patients included, mean (SD) 4

, Trainee supervisors were general practitioners (GPs) involved in teaching, GPs who were university lecturers or those who received students for internship; SD, standard deviation, p.8

, Hypertension, p.72

, Type 2 diabetes, p.22

. Hypercholesterolaemia,

, SF-36 mental health score, mean (SD) 60

, SF-36 physical health score

, Patient adherence, vol.38, pp.46-90

, Patient adherence, vol.3

, Mortality, vol.10115

C. Hospitalisation-for and . Decompensation,

, Hospitalisation not for CHF decompensation

. Hospitalisation,

. Hospitalisation,

, Total number of days of hospitalisation 1037, p.867

, Death or HF hospitalisation

, Number of cardiologist visits/patient, mean (SD) 3.1 (2.2) 3, p.92

, 1 n = 17 missing data for New York Heart Association stage

, 2 n = 20 missing data for body mass index

, 3 n = 13 missing data for adherence. #Additional general practitioner visits (in addition to those dedicated to the study)

, Cumulative number of patients with acute heart failure. 0" 10" 20" 30" 40" 50" 60" 70" 80" 90" 100" M4" M7" M10" M13" M19" Cases, Figure, vol.316

, Evolution of New York Heart Association stages during follow-up. 0" 20" 40" 60" 80" 100" 120" 140, Figure, vol.4

, Pa1ents" I" II" III