Patient-Reported Compliance in older age patients with chronic heart failure

Background: Palliative care needs of patients with chronic heart failure are poorly recognised. Policy makers advise a patient-centred approach to holistically assess patients’ needs and care goals. Patient-reported outcome measures are proposed to facilitate patient-centred care. Aim: To explore whether and how a palliative care–specific patient-reported outcome intervention involving the Integrated Palliative care Outcome Scale influences patients’ experience of patient-centred care in nurse-led chronic heart failure disease management clinics. Design: A feasibility study using a parallel mixed-methods embedded design was undertaken. The qualitative component which examined patients and nurses experience of the intervention is reported here. Semi-structured interviews were conducted and analysed using framework analysis. Setting/participants: Eligible patients attended nurse-led chronic heart failure disease management clinics in two tertiary referral centres in Ireland with New York Heart Association functional class II–IV. Nurses who led these clinics were eligible for inclusion. Results: In all, 18 patients and all 4 nurses involved in the nurse-led clinics were interviewed. Three key themes were identified: identification of unmet needs, holistic assessment and patient empowerment. The intervention impacted on processes of care by enabling a shared understanding of patients’ symptoms and concerns, facilitating patient–nurse communication by focusing on these unmet needs and empowering patients to become more involved in clinical discussions. Conclusion: This Integrated Palliative care Outcome Scale–based intervention empowered patients to become more engaged in the clinical consultation and to highlight their unmet needs. This study adds to the evidence for the mechanism of action of patient-reported outcome measures to improve patient-centred care and will help inform outcome selection for future patient-reported outcome measure research.

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Feasibility and acceptability of a patient-reported outcome intervention in chronic heart failure

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2017-001355 ◽

2017 ◽

Vol 7 (4) ◽

pp. 470-479 ◽

Cited By ~ 16

Author(s):

Pauline M Kane ◽

Barbara A Daveson ◽

Karen Ryan ◽

Clare I Ellis-Smith ◽

Niall G Mahon ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Patient Reported Outcome ◽

Patient Reported

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The Association Between Patient-reported Clinical Factors and 30-day Acute Care Utilization in Chronic Heart Failure

Medical Care ◽

10.1097/mlr.0000000000001258 ◽

2020 ◽

Vol 58 (4) ◽

pp. 336-343 ◽

Cited By ~ 1

Author(s):

Jinying Chen ◽

Rajani Sadasivam ◽

Amanda C. Blok ◽

Christine S. Ritchie ◽

Catherine Nagawa ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Acute Care ◽

Care Utilization ◽

Clinical Factors ◽

Patient Reported ◽

Acute Care Utilization

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Patient-Reported Outcomes in Chronic Heart Failure

JACC Heart Failure ◽

10.1016/j.jchf.2016.04.010 ◽

2016 ◽

Vol 4 (10) ◽

pp. 791-804 ◽

Cited By ~ 18

Author(s):

Mitchell A. Psotka ◽

Robyn von Maltzahn ◽

Milena Anatchkova ◽

Irene Agodoa ◽

Dina Chau ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Patient Reported Outcomes ◽

Patient Reported

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Relationship between changing patient-reported outcomes and subsequent clinical events in patients with chronic heart failure: insights from HF-ACTION

European Journal of Heart Failure ◽

10.1002/ejhf.1299 ◽

2018 ◽

Vol 21 (1) ◽

pp. 63-70 ◽

Cited By ~ 11

Author(s):

Nancy Luo ◽

Christopher M. O'Connor ◽

Lauren B. Cooper ◽

Jie-Lena Sun ◽

Adrian Coles ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Patient Reported Outcomes ◽

Clinical Events ◽

Patient Reported

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Piloting a web-based systematic collection and reporting of patient-reported outcome measures and patient-reported experience measures in chronic heart failure

BMJ Open ◽

10.1136/bmjopen-2020-037754 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037754

Author(s):

Francesca Pennucci ◽

Sabina De Rosis ◽

Claudio Passino

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Outcome Measures ◽

Health Workers ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Population Characteristics ◽

Web Based ◽

Patient Reported ◽

Systematic Collection

ObjectivesTo evaluate the feasibility of a digital and continuous collection and reporting of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for chronic heart failure (CHF).DesignA single-site pilot study was settled for evaluating the feasibility of the intervention, both using qualitative and quantitative data (ie, workshop, surveys).SettingThe pilot has been implemented in a Tuscan specialised hospital (Italy).Participants162 patients were involved. Inclusion criteria were: a previous diagnosis of HF, age ≥18 years, absence of cognitive impairment or active tumours, ability to provide informed consent to study participation.InterventionThe continuous collection and reporting of PROMs and PREMs has been designed and implemented in 2018. PREMs questionnaires for patients were developed, while Kansas City Cardiomyopathy Questionnaire-12 was used for assessing PROMs. Questionnaires are administered at specific time points: discharge; 30 days, 7 and 12 months after the discharge. Enrolment of patients, administration and real-time reporting of questionnaires are carried on through a digital platform.Outcome measuresEnrolment, response and drop-out rates were considered to assess the feasibility of the intervention. Qualitative data were collected during meetings and workshops with health workers. The representativeness of the recruited sample with respect to the population characteristics was also evaluated.ResultsThe system has been successfully implemented during 2018. Response rates have been consistently above 50%, demonstrating patients’ transversal willingness to participate. All the involved stakeholders acknowledged the feasibility of the design. The recruited sample is significantly different in terms of age and educational level compared with the overall population characteristics.ConclusionIt is possible to run a web-based systematic collection and reporting system for CHF patient-reported data. Systematic collection and reporting of PROMs and PREMs data allows professionals to increasingly assume CHF patient perspective in their daily work. Limitations will be used to improve the system.

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Assessment of chronic disease self-management in patients with chronic heart failure based on the MCID of patient-reported outcomes by the multilevel model

10.21203/rs.3.rs-40363/v3 ◽

2020 ◽

Author(s):

Jing Tian ◽

Jinghua Zhao ◽

Qing Zhang ◽

Jia Ren ◽

Linai Han ◽

...

Keyword(s):

Heart Failure ◽

Chronic Disease ◽

Chronic Heart Failure ◽

Clinical Significance ◽

Multilevel Models ◽

Threshold Value ◽

Patient Reported Outcome ◽

Self Management ◽

Low Sodium Diet ◽

Patient Reported

Abstract Purpose: The minimal clinically important difference (MCID) of a patient-reported outcome (PRO) represents the threshold value of the change in the score for that PRO. It is deemed to have an important implication in clinical management. This study was performed to evaluate the clinical significance of chronic disease self-management (CDSM) for patients with chronic heart failure based on the MCID of the chronic heart failure - PRO measure (CHF-PROM).Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from July 2018. Advice of CDSM was provided in written form at discharge to all patients. Information regarding CHF-PROM and CDSM were collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of CDSM for CHF-PROM scores, as well as its physical and psychological domains. MCID changes of the PRO were introduced and compared with β values of CDSM obtained from the multi-level models to further evaluate the clinical significance.Results: Scores for CHF-PROM improved significantly after discharge. The multilevel models showed that a regular schedule, avoidance of over-eating, a low-sodium diet and exercise increased scores on CHF-PROM. Compared with the MCID, avoidance of over-eating (12.39 vs. 9.75) and maintenance of a regular schedule often (10.98 vs. 9.75), and exercise almost every day (11.36 vs. 9.75) reached clinical significance for the overall summary. Avoidance of over-eating (5.88 vs. 4.79) and a regular schedule almost every day (4.96 vs. 4.79) reached clinical significance for the physical scores. Avoidance of over-eating half of the time (5.26 vs. 4.87) and a regular schedule almost every day (5.84 vs. 4.87) demonstrated clinical significance for the psychological scores.Conclusions: This study observed an association of avoidance of over-eating and maintenance of a regular schedule with the improvement of CHF-PROM. It provides further evidence for management of heart failure.

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Influence of self-management on patient-reported outcomes for individuals with chronic heart failure: a multilevel model approach from a longitudinal study

10.21203/rs.3.rs-22271/v1 ◽

2020 ◽

Author(s):

Jing Tian ◽

Jinghua Zhao ◽

Qing Zhang ◽

Jia Ren ◽

Linai Han ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Patient Reported Outcomes ◽

Multilevel Models ◽

Management Strategies ◽

Angiotensin Converting Enzyme Inhibitors ◽

Self Management ◽

Converting Enzyme Inhibitors ◽

Patient Reported ◽

Improve Patient

Abstract Purpose: Self-management is highly heterogenous in patient-reported outcomes in individuals with chronic heart failure and lacks a clinical definition. The aim of this study was to identify clinically meaningful strategies that improve patient-reported outcomes in those with chronic heart failure.Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from May 2017 to May 2019. Self-management advice was provided in written form at discharge. Information regarding chronic heart failure in patient-reported outcomes and self-management was collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of self-management strategies for patient-reported outcome of chronic heart failure (CHF-PRO) scores, as well as its physical and psychological domains. Minimal clinically important difference was introduced to further evaluate clinical significance.Results: Scores for CHF-PRO improved significantly after discharge. A regular schedule, avoidance of over-eating, and a low-sodium diet increased scores on patient-reported outcomes, including overall scores and physical and psychological scores. In addition, exercise improved patient-reported outcomes and its physical domain. The use of angiotensin-converting enzyme inhibitors also increased physical scores. Among these variables, a regular daily schedule and avoidance of over-eating almost every day reached clinical significance for CHF-PRO scores, as well as its physical and psychological domains.Conclusions: Self-management, especially the avoidance of over-eating and maintenance of a regular schedule, should be implemented to improve patient-reported outcomes in those with chronic heart failure.Trial registration: 2018LL128, January 2, 2018.

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Influence of self-management on patient-reported outcomes for individuals with chronic heart failure: a multilevel model approach from a longitudinal study

10.21203/rs.3.rs-16907/v1 ◽

2020 ◽

Author(s):

Jing Tian ◽

Jinghua Zhao ◽

Qing Zhang ◽

Jia Ren ◽

Linai Han ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Significance ◽

Patient Reported Outcomes ◽

Multilevel Models ◽

Management Strategies ◽

Self Management ◽

Converting Enzyme Inhibitors ◽

Patient Reported ◽

Improve Patient

Abstract Purpose: Self-management is highly heterogenous in patient-reported outcomes in individuals with chronic heart failure and lacks a clinical definition. The aim of this study was to identify clinically meaningful strategies that improve patient-reported outcomes in those with chronic heart failure. Methods: A total of 555 patients with heart failure were enrolled. Self-management advice was provided in written form at discharge. Information regarding chronic heart failure in patient-reported outcomes and self-management was collected during follow-up. Multilevel models were applied to evaluate the effects of self-management strategies for patient-reported outcome of chronic heart failure (CHF-PRO) scores, as well as its physical and psychological domains. Minimal clinically important difference was introduced to further evaluate clinical significance. Results: Scores for CHF-PRO improved significantly after discharge. A regular schedule, avoidance of over-eating, and a low-sodium diet increased scores on patient-reported outcomes, including overall scores and physical and psychological scores. In addition, exercise improved patient-reported outcomes and its physical domain. The use of angiotensin-converting enzyme inhibitors also increased physical scores. Among these variables, a regular daily schedule and avoidance of over-eating almost every day reached clinical significance for CHF-PRO scores, as well as its physical and psychological domains. Conclusions: Self-management, especially the avoidance of over-eating and maintenance of a regular schedule, should be implemented to improve patient-reported outcomes in those with chronic heart failure.

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