scholarly journals Improving outpatient care in chronic heart failure

2021 ◽  
Vol 28 (4) ◽  
pp. 14-24
Author(s):  
S. A. Boytsov ◽  
F. T. Ageev ◽  
O. N. Svirida ◽  
Z. N. Blankova ◽  
Yu. L. Begrambekova ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Medical Staff ◽  
Outpatient Care ◽  
Hospital Admissions ◽  
Quality Criteria ◽  
Training Programme ◽  
Adherence To Medication ◽  
National Medical ◽  
Outpatient Prescriptions

Despite advances in pharma and high-technology medicine, the rate of burdensome hospital admissions and mortality in patients with chronic heart failure (CHF) remains high. Over half of all admission-entailing decompensations have been repeatedly shown to emerge from non-compliance with outpatient prescriptions. Poor adherence to medication and non-medication treatment can only be broken by improving the patient’s awareness of the disease and his closer monitoring by healthcare professionals. The power of clinical and laboratory illness monitoring in line with the recommended quality criteria of medical aid in heart failure (HF) is strongly limited today by time resources available in outpatient and midwifery clinics. Meanwhile, an international and certain domestic experience has been built up to run CHF outpatient centres with involvement of specially-trained nursing and senior medical staff. Analytic evidence on such centres suggests a reduction in mortality and hospitalisation rate among the visiting patients. To combat existing drawbacks of CHF outpatient care, the National Medical Research Center of Cardiology in alliance with the Specialist Society of Heart Failure have developed the nurses’ guidelines for CHF rooms and are launching a medical staff training programme to manage CHF rooms, registry and data analysis. Furthermore, a procedure has been developed for patient routing to regional CHF outpatient cabinets that is being actively deployed in the Tyumen Region.

scholarly journals Changes of Natriuretic Peptides Predict Hospital Admissions in Patients With Chronic Heart Failure

2014 ◽  
Vol 2 (2) ◽  
pp. 148-158 ◽  
Author(s):  
Gianluigi Savarese ◽  
Francesca Musella ◽  
Carmen D’Amore ◽  
Enrico Vassallo ◽  
Teresa Losco ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Natriuretic Peptides ◽  
Hospital Admissions

scholarly journals Should Pharmacists Be Included in a Core Team to Reduce Hospital Admissions and Mortality for Patients With Chronic Heart Failure?

2015 ◽  
Vol 2 (2) ◽  
pp. 102
Author(s):  
Indubala Vardhan ◽  
Yvonne E Grant ◽  
Carmela Astrea ◽  
Joanna Wolmer ◽  
Paula Hinz
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Hospital Admissions

scholarly journals Clinical efficacy of various forms of continuing education of patients with chronic heart failure

2013 ◽  
Vol 4 (1) ◽  
pp. 55-62
Author(s):  
G. P Arutyunov ◽  
A. V Evzerikhina ◽  
A. K Rylova ◽  
V. I Lobzeva
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Performance Test ◽  
Hospital Admissions ◽  
Clinical Status ◽  
Developed Countries ◽  
Left Ventricular ◽  
Structured Learning ◽  
Lv Function ◽  
Minute Walk

Data from numerous epidemiological studies indicate that in many developed countries, heart failure is one of the most common, progressive and predictive of adverse complications of diseases of the cardiovascular system. At the moment, that is a rather acute problem of cardiac rehabilitation of such patients. The purpose of our study was to investigate the effect of various forms of structured learning in special schools for CHF patients on the clinical course and prognosis. Materials and Methods: This study consisted of two phases, including 158 patients with chronic heart failure II–III FC. Evaluated the survival of the knowledge, clinical status, distance of a 6-minute walk, Minnesota QoL questionnaire, adherence to therapy, the frequency of hospital admissions for heart failure decompensation, referral to the clinic, the frequency of deaths, the level of CRP, LV function the results of echocardiography. The results: the use of interactive learning will significantly improve patient compliance to treatment (D=5%), which in turn significantly improved the clinical condition of patients, quality of life, performance test, 6-minute walk, and left ventricular function, as well as reduced the number of hospitalizations with circulatory decompensation (1,6-times), and uptake to the clinic (up to 0,5 times a month). Thus, the use of interactive patient education is an integral part of the cardiorehabilitation events in patients with CHF.

scholarly journals Outpatient nursing support for self-monitoring in patients with chronic heart failure

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254019
Author(s):  
Chinatsu Taniguchi ◽  
Natsuko Seto ◽  
Yasuko Shimizu
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Support System ◽  
Outpatient Care ◽  
Outpatient Setting ◽  
The Body ◽  
Inductive Method ◽  
Convenience Sample ◽  
Nursing Support ◽  
Self Monitoring

Background Early symptoms of worsening heart failure are difficult for patients to detect and manage, contributing to the high readmission rate for worsening heart failure. Thus, it is important to promote self-monitoring and to support patients in recognizing and interpreting their symptoms. This study aimed to explore the ways in which specialized nurses in the outpatient setting provide support for self-monitoring in patients with chronic heart failure in Japan. Methods This exploratory study adopted a qualitative study design. The participants were a convenience sample of five nurses certified in chronic heart failure nursing and one advanced practice nurse certified in chronic care nursing, all with experience in outpatient nursing in Japan. Data were collected from June 2017 to October 2017 through semi-structured one-on-one interviews and were analyzed using an established qualitative inductive method. Results The analysis identified seven themes describing the nursing support provided by the study participants. Among these were three themes describing different forms of direct support for self-monitoring: “Encourage patients to reflect on their own,” “Support touching the body and developing body awareness,” and “Support sharing the task.” Two themes described practice perspectives: “Support self-monitoring that is not overly sensitive” and “Support connection with the patient’s life.” Two final themes described contextual factors in the outpatient care setting: “Struggling with constraints and powerlessness” and “Building a support system in the outpatient setting.” Conclusions The findings provide a practice for nurses promoting self-monitoring in patients with chronic heart failure in the outpatient setting. The study findings inform and provide goals for the support of self-monitoring in patients with heart failure and also, suggest the need to establish a strong support system for outpatient care in Japan.

scholarly journals Exercise-Based Rehabilitation Delivery Models in Comorbid Chronic Pulmonary Disease and Chronic Heart Failure

2021 ◽  
Vol 8 ◽  
Author(s):  
Audrey Borghi-Silva ◽  
Adriana S. Garcia-Araújo ◽  
Eliane Winkermann ◽  
Flavia R. Caruso ◽  
Daniela Bassi-Dibai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Pulmonary Disease ◽  
Exercise Capacity ◽  
Aging Process ◽  
Hospital Admissions ◽  
Negative Impact ◽  
Hospital Readmissions ◽  
Chronic Obstructive ◽  
Delivery Models

Among the most prevalent multimorbidities that accompany the aging process, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) stand out, representing the main causes of hospital admissions in the world. The prevalence of COPD coexistence in patients with CHF is higher than in control subjects, given the common risk factors associated with a complex process of chronic diseases developing in the aging process. COPD-CHF coexistence confers a marked negative impact on mechanical-ventilatory, cardiocirculatory, autonomic, gas exchange, muscular, ventilatory, and cerebral blood flow, further impairing the reduced exercise capacity and health status of either condition alone. In this context, integrated approach to the cardiopulmonary based on pharmacological optimization and non-pharmacological treatment (i.e., exercise-based cardiopulmonary and metabolic rehabilitation) can be emphatically encouraged by health professionals as they are safe and well-tolerated, reducing hospital readmissions, morbidity, and mortality. This review aims to explore aerobic exercise, the cornerstone of cardiopulmonary and metabolic rehabilitation, resistance and inspiratory muscle training and exercise-based rehabilitation delivery models in patients with COPD-CHF multimorbidities across the continuum of the disease. In addition, the review address the importance of adjuncts to enhance exercise capacity in these patients, which may be used to optimize the gains obtained in these programs.

scholarly journals Use of Natriuretic Peptides to Guide and Monitor Heart Failure Therapy

2012 ◽  
Vol 58 (1) ◽  
pp. 62-71 ◽  
Author(s):  
A Mark Richards ◽  
Richard W Troughton
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Natriuretic Peptides ◽  
Hospital Admissions ◽  
Systolic Heart Failure ◽  
Prognostic Indicators ◽  
Full Spectrum ◽  
Cardiac Natriuretic Peptides ◽  
Design Characteristics ◽  
And Function

Abstract BACKGROUND Plasma B-type cardiac natriuretic peptides reflect cardiac structure and function and have proven roles in assisting in the diagnosis of acute heart failure. They are independent prognostic indicators across the full spectrum of cardiovascular disease. Serial changes in plasma B-type cardiac natriuretic peptides parallel prognosis in chronic heart failure. Beneficial responses to medications and devices used in the treatment of heart failure are associated with decreases in plasma B-type peptide concentrations. This effect has led to the hypothesis that intensified treatment directed at reducing B-peptide concentrations may improve outcomes in heart failure. CONTENT The efficacy of serial measurements of plasma B-type peptides in guiding titration of therapy for chronic heart failure has been the subject of several randomized controlled trials reported in the peer-reviewed literature since 2000. These reports are summarized in this review. Trial design, characteristics of the heart-failure population studied, duration of follow-up, exact end points recorded, and target peptide concentrations pursued all differ somewhat between trials. In addition, in studies in which benefits were seen, the exact mechanisms mediating the improvements in outcome were unclear. However, an overall consistency is emerging that is supported by 2 metaanalyses. SUMMARY In aggregate the existing trial data suggest that adjustment of treatment in chronic heart failure according to serial B-type peptide measurements, used in conjunction with established clinical methods, is likely to reduce cardiac mortality and hospital admissions with heart failure, at least in patients with systolic heart failure who are younger than 75 years and relatively free of comorbidities.

scholarly journals Clinical efficacy of acute respiratory viral infections prevention in patients with chronic heart failure

2019 ◽  
Vol 91 (3) ◽  
pp. 36-41 ◽  
Author(s):  
A V Budnevsky ◽  
A D Shurupova ◽  
A Ya Kravchenko ◽  
R E Tokmachev
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Standard Therapy ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Clinical Course ◽  
Functional Class ◽  
Dynamic Monitoring ◽  
Interferon Inducer ◽  
Respiratory Viral Infections

The aim of the study was to evaluate the ARVI prevention effectiveness in patients with chronic heart failure (CHF) using interferon inducer amixin. Materials and methods. Conducted a comprehensive survey, dynamic monitoring and treatment of 60 patients aged from 49 to 70 years (mean age 60.25±4.57 years, 17 men and 43 women) with CHF with preserved ejection fraction of left ventricle (LVEF) (≥50%), II-III functional class (FC) according to the classification of new York Heart Association (NYHA), which developed as a result of coronary heart disease (CHD), hypertensive disease (HD). Of these, 30 patients (group 1) on the background of standard therapy for CHF received for the prevention of ARVI tiloron (Amixin) at a dose of 125 mg once a week for 6 weeks, two courses for 1 year. Group 2 patients received only standard therapy for CHF. Results. A decrease in the frequency of ARVI in patients with CHF treated with Amixin was found, which was accompanied by a decrease in the severity of subclinical inflammation by reducing the production of proinflammatory (IL-1β) and increasing the production of anti-inflammatory (IL-10) cytokines, reducing neurohumoral activation (reducing levels of aldosterone and Nt-proBNP), increasing the level of α- and γ-interferon. The positive dynamics of biomarkers of systemic inflammation and neurohormonal activation explains the improvement of the clinical course in patients with CHF (increase of tolerance to physical loads, reducing the number of visits to General practitioner and hospital admissions in the hospital during 12 months of observation). Conclusion. A promising approach to the prevention of SARS in patients with CHF is course therapy with Amixin (2 times a year before the seasonal rising in the incidence of respiratory viral infections and influenza), which allows to achieve both decreasing in the frequency of SARS per year, and improvement the clinical course of CHF.

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