Self Management, Symptom Monitoring and Associated Factors in People with Heart Failure Living in the Community

2010 ◽  
Vol 9 (3) ◽  
pp. 153-160 ◽  
Author(s):  
Robyn Gallagher
Keyword(s):  
Heart Failure ◽  
Associated Factors ◽  
Self Management ◽  
Symptom Monitoring

Self-management in diabetes, asthma and heart failure: Feasibility of a minimal intervention program

2002 ◽  
Author(s):  
K. Schreurs ◽  
V. Colland ◽  
R. Kuijer ◽  
D. de Ridder ◽  
Th. van Elderen
Keyword(s):  
Heart Failure ◽  
Intervention Program ◽  
Self Management ◽  
Minimal Intervention

Common Comorbidities that Alter Heart Failure Prognosis - shaping new thinking for practice.

2020 ◽  
Vol 16 ◽  
Author(s):  
Pupalan Iyngkaran ◽  
Merlin Thomas ◽  
John D Horowitz ◽  
Paul Komesaroff ◽  
Michael Jelinek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Management ◽  
Community Practice ◽  
Elderly Age ◽  
Medical Specialists ◽  
General Internal ◽  
Allied Health Care ◽  
Speciality Training ◽  
New Thinking ◽  
Failure Prognosis

: At least half of all heart failure (CHF) patients will have a comorbidity that could be undertreated, requires additional speciality input and/or polypharmacy. These patients are then at risk from iatrogenic and disease related complications and readmissions if not closely supervised. Common comorbidities of relevance are cardiorenal and cardiometabolic syndromes (DM, obesity, OSA), chronic airways disease, elderly age and accompanying therapeutic optimisation. The structure of community practice often leaves primary, speciality and allied health care in silos. For example, cardiology speciality training in Australia creates excellent sub-specialists to deliver on the diagnostics and therapeutic advances. A casualty of this process has been gradual alienation of general cardiology towards general internal medical specialists and GP's. The consequences are largely noticed in community practice. The issue are compounded by suboptimal communication of information. This review explores these issues from a cardiology sub-speciality lens, firstly cross speciality areas important for cardiologist to maintain their skill and finally a brief overview of disease management and identifying game changing common denominators such as endothelial dysfunction and self-management.

A patient-centered mobile intervention to promote self-management and improve patient outcomes in chronic heart failure: The ManageHF4Life trial (Preprint)

2020 ◽  
Author(s):  
Michael P. Dorsch ◽  
Karen B. Farris ◽  
Brigid E. Rowell ◽  
Scott L. Hummel ◽  
Todd M. Koelling
Keyword(s):  
Heart Failure ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Control Group ◽  
Patient Centered ◽  
Self Monitoring ◽  
Heart Failure Questionnaire

BACKGROUND Successful management of heart failure (HF) involves guideline based medical therapy as well as self-care behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management. OBJECTIVE Evaluate the effectiveness of a mobile application intervention that enhances self-monitoring on health-related quality of life, self-management, and reduces HF readmissions. METHODS A single-center randomized controlled trial was performed. Patients greater than 45 years of age and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group used a mobile application (App). The intervention prompted daily self-monitoring and promoted self-management. The control group (No App) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire and recurrent HF admissions. RESULTS Eighty-three patients were enrolled and completed all baseline assessments. Baseline characteristics were similar between groups with the exception of HF etiology. The App group had a reduced MLHFQ at 6 weeks (37.5 ± 3.5 vs. 48.2 ± 3.7, P=0.039) but not at 12 weeks (44.2 ± 4 vs. 45.9 ± 4, P=0.778) compared to No App. There was no effect of the App on the SCHFI at 6 or 12 weeks. The time to first HF admission was not statistically different between the App versus No App groups (HR 0.89, 95% CI 0.39-2.02, P=0.781) over 12 weeks. CONCLUSIONS The mobile application intervention improved MLHFQ at 6 weeks, but did not sustain its effects at 12 weeks. No effect was seen on HF self-care. Further research is needed to enhance engagement in the application for a longer period of time and to determine if the application can reduce HF admissions in a larger study. CLINICALTRIAL NCT03149510

scholarly journals Weight loss early after discharge predicts the risk of rehospitalization in non-obese patients with heart failure preserved ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Kamisaka ◽  
K Kamiya ◽  
K Iwatsu ◽  
N Iritani ◽  
Y Iida ◽  
...  
Keyword(s):  
Heart Failure ◽  
Weight Loss ◽  
Regression Analysis ◽  
Ejection Fraction ◽  
Associated Factors ◽  
Clinical Characteristics ◽  
Obese Patients ◽  
Preserved Ejection Fraction ◽  
Kaplan Meier ◽  
Worse Prognosis

Abstract Background Weight loss (WL) has been considered as a prognostic factor in heart failure with reduced ejection fraction (HFrEF). However, the prognosis and associated factors of WL in heart failure with preserved ejection fraction (HFpEF) have remained unclear. Purpose This study aimed to examine the prevalence, prognosis, and clinical characteristics of worse prognosis based on the identified WL after discharge in HFpEF. Methods The study was conducted as a part of a multicenter cohort study (Flagship). The cohort study enrolled ambulatory HF who hospitalized due to acute HF or exacerbation of chronic HF. Patients with severe cognitive, psychological disorders or readmitted within 6-month after discharge were excluded in the study. WL was defined as ≥5% weight loss in 6-month after discharge and HFpEF was defined as left ventricular ejection fraction (LVEF) ≥50% at discharge. Age, gender, etiology, prior HF hospitalization, New York Heart Association (NYHA) class, brain natriuretic peptide (BNP) or N-terminal-proBNP (NT-proBNP), anemia (hemoglobin; male <13g/dL, female <12g/dL), serum albumin, Geriatric Depression Scale, hand grip strength and comorbidities were collected at discharge. Patients were stratified according to their body mass index (BMI) at discharge as non-obese (BMI <25) or obese (BMI ≥25). We analyzed the association between WL and HF rehospitalization from 6 month to 2 years after discharge using Kaplan-Meier curve analysis and Cox regression analysis adjusted for age and gender, and clinical characteristics associated to worse prognosis in WL using logistic regression analysis adjusted for potential confounders in HFpEF. Results A total of 619 patients with HFpEF were included in the analysis. The prevalence of WL was 12.9% in 482 non-obese and 15.3% in 137 obese patients. During 2 years, 72 patients were readmitted for HF (non-obese: 48, obese: 24). WL in non-obese independently associated with poor prognosis (hazard ratio: 2.2: 95% confidence interval: 1.13–4.25) after adjustment for age and sex, while WL in obese patients did not. Logistic regression analysis chose age (odds ratio 1.02 per 1 year; 1.00–1.05), anemia (2.14; 1.32–3.48), and BNP ≥200pg/mL or NT-proBNP ≥900pg/mL (1.83; 1.18–2.86) as independent associated factors for worse prognosis of WL in non-obese patients. Conclusion In HFpEF, WL in early after discharge in non-obese elderly patients may be a prognostic indicator for HF rehospitalization. HF management including WL prevention along with controlling anemia is likely to improve prognosis in this population. Kaplan Meier survival curves Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): A Grant-in-Aid for Scientific Research (A) from the Japan Society for the Promotion of Science

scholarly journals Preventing the rebound: improving care transition in hospital discharge processes

2010 ◽  
Vol 34 (4) ◽  
pp. 445 ◽  
Author(s):  
Ian A. Scott
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Older Patients ◽  
Single Component ◽  
Self Management ◽  
Controlled Trials ◽  
High Risk Patients ◽  
Patients With Heart Failure ◽  
Risk Patients ◽  
Multicomponent Interventions

Background.Unplanned readmissions of recently discharged patients impose a significant burden on hospitals with limited bed capacity. Deficiencies in discharge processes contribute to such readmissions, which have prompted experimentation with multiple types of peridischarge interventions. Objective.To determine the relative efficacy of peridischarge interventions categorised into two groups: (1) single component interventions (sole or predominant) implemented either before or after discharge; and (2) integrated multicomponent interventions which have pre- and postdischarge elements. Design.Systematic metareview of controlled trials. Data collection.Search of four electronic databases for controlled trials or systematic reviews of trials published between January 1990 and April 2009 that reported effects on readmissions. Data synthesis.Among single-component interventions, only four (intense self-management and transition coaching of high-risk patients and nurse home visits and telephone support of patients with heart failure) were effective in reducing readmissions. Multicomponent interventions that featured early assessment of discharge needs, enhanced patient (and caregiver) education and counselling, and early postdischarge follow-up of high-risk patients were associated with evidence of benefit, especially in populations of older patients and those with heart failure. Conclusion.Peridischarge interventions are highly heterogenous and reported outcomes show considerable variation. However, multicomponent interventions targeted at high-risk populations that include pre- and postdischarge elements seem to be more effective in reducing readmissions than most single-component interventions, which do not span the hospital–community interface. What is known about this topic?Unplanned readmissions within 30 days of hospital discharge are common and may reflect deficiencies in discharge processes. Various peridischarge interventions have been evaluated, mostly single-component interventions that occur either before or after discharge, but failing to yield consistent evidence of benefit in reducing readmissions. More recent trials have assessed multicomponent interventions which involve pre- and postdischarge periods, but no formal review of such studies has been undertaken. What does this paper add?With the exception of intense self-management and transition coaching of high-risk patients, and nurse home visits and telephonic support for patients with heart failure, single-component interventions were ineffective in reducing readmissions. Multicomponent interventions demonstrated evidence of benefit in reducing readmissions by as much as 28%, with best results achieved in populations of older patients and those with heart failure. What are the implications for practitioners and managers?Hospital clinicians and managers should critically review and, where appropriate, modify their current discharge processes in accordance with these findings and negotiate the extra funding and personnel required to allow successful implementation of multicomponent discharge processes that transcend organisational boundaries.

The Development of a Situation-Specific Nurse-Led Culturally Tailored Self-Management Theory for Chinese Patients With Heart Failure

2021 ◽  
pp. 104365962110239
Author(s):  
Yuanyuan Jin ◽  
Youqing Peng
Keyword(s):  
Heart Failure ◽  
Development Strategy ◽  
Theory Development ◽  
Management Theory ◽  
Chinese Patients ◽  
Self Management ◽  
Integrative Approach ◽  
Management Interventions ◽  
Culturally Tailored ◽  
Patients With Heart Failure

Introduction: Self-management is essential for treating heart failure (HF). Culture influences the ability to cope, negotiate, and adopt self-management behaviors. However, current HF self-management interventions for Chinese patients do not take culture into consideration. The aim of this article is to describe the development of a situation-specific nurse-led culturally tailored self-management theory for Chinese patients with HF. Methodology: An integrative approach was used as theory development strategy for the situation-specific theory. Results: Based on theoretical and empirical evidence, and theorists’ experiences from research and practice, a nurse-led culturally tailored self-management theory for Chinese patients with HF was developed. Discussion: Researchers addressing health phenomena often have difficulty defining, conceptualizing, and operationalizing culture. The situation-specific theory developed in this study has the potential to increase specificity (i.e., logical adequacy and usefulness) of existing theories while informing the application to nursing practice. Further critique and testing of the situation-specific theory is warranted.

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