Assessment of Pharmacist Intervention Among Post Hospital Discharge Patients with Moderate and Severe Acute Heart Failure

Al Mustansiriyah Journal of Pharmaceutical Sciences ◽

10.32947/ajps.19.04.0418 ◽

2019 ◽

pp. 50-60

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Medication Adherence ◽

Acute Heart Failure ◽

Hospital Readmission ◽

Severe Heart Failure ◽

Pharmacist Intervention ◽

Control Group ◽

Moderate Heart Failure

Background: Acute heart failure is the most common cause for hospitalization and the third highest cause of hospital readmission with nearly quarter of patients being re hospitalized within 30 days after discharge. Implementation of Clinical pharmacists in coordinated inpatient care, discharge planning and outpatient care result in significant improvements in adverse drug events reduction, medication adherence, quality of life and patient knowledge. Objective: Evaluating pharmacist- based program for patients with moderate and sever acute heart failure via improving summary discharge in reduction hospital readmission, enhancing medications adherence and improve quality of life. Patients and Methods: This prospective study was carried out under interventional pharmacist- based program carried out on 50 patients whom completed this study, they were randomly allocated to two groups, program group who are receiving program for assessment and review starting from 30 minutes pre hospital discharge till 12 weeks. The control group on usual care which include physician-based discharge summary, routine laboratory test without pharmacist intervention (25 patients for each group). Result: After 12 weeks of follow up among program patients in comparison with control group, study findings revealed significant improvement in self-care heart failure index domains (maintenance, management, confidence and total SCHFI score (P=0.001) in both moderate heart failure (NYHAIII) and severe heart failure (NYHAIV) groups, also increase in domains of belief medication questionnaire whether specific necessity and specific concern domains (P=0.001) or decreased in general harm and general overuse (P=0.001) in both moderate and severe heart failure. Moreover, increase in all domains of WHO quality of life questionnaire (WHOQOL) (P=0.001) in both moderate and sever heart failure with predominant improvement in moderate heart failure. Both serum brain natriuretic peptide (P=0.001) and cardiac troponin I (P<0.01) level were decreased in patients with moderate and severe HF and ejection fraction was improved (P=0.03) only among patients with severe HF of program group. Conclusion: Implementing pharmacist- based management program for patients with moderate and severe acute heart failure via summary discharge markedly improve disease awareness, medication adherence, reduced hospital readmission and total mortality at the end-line of study among intervention patients compared to the usual care.

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Effect Of Comprehensive Assessment of Nursing Mode on The Care Ability of Family Members and Quality of Life of Patients with Acute Heart Failure

Tobacco Regulatory Science ◽

10.18001/trs.7.5.1.71 ◽

2021 ◽

Vol 7 (5) ◽

pp. 3012-3021

Author(s):

Lei Wang ◽

Chen Ye ◽

DongMei Liu ◽

ZhenZhen Xu

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Acute Heart Failure ◽

Family Care ◽

Nursing Intervention ◽

Comprehensive Assessment ◽

Self Management ◽

Control Group ◽

Study Group

Objective To explore the effect of comprehensive assessment of nursing mode on the care ability of family members and quality of life of patients with acute heart failure. Methods 118 patients with acute heart failure treated in our hospital were randomly divided into two groups: control group (n = 59) treated with routine nursing intervention and study group (n = 59) treated with comprehensive nursing mode intervention. Care was initiated at the time of admission until discharge. Family care, changes in cardiac function, quality of life, compliance, satisfaction, and self-management, 6-minute walk test (6MWT), and New York Heart Association (NYHA) classification were compared between the two groups. Results The scores of family care ability in the study group were lower than those in the control group (P=0.000). After nursing intervention, the levels of CO and LVEF in the study group and the control group were higher than those before intervention (P<0.05), and the levels of LVEDD and HR in the study group were lower than those in the control group (P=0.000). The scores of qualities of life in the study group were higher than those in the control group (P=0.000). The compliance rate in the study group was higher than that in the control group (P=0.002). The satisfaction degree in the study group was higher than that in the control group (P<0.05). The score of self-management in study group was higher than that in control group (P=0.000). The 6MWT level at discharge in the study group was higher than that in the control group after intervention. The odds of NYHA functional class II in the study group were higher than that in the control group. The odds of classes III and IV were lower than that in the control group, but the difference had no statistical significance (P=0.087). Conclusion: Comprehensive assessment of nursing mode intervention in patients with acute heart failure is beneficial to the improvement of the patient’s family’s nursing ability and quality of life, as well as the improvement of cardiac function, the improvement of the patient’s compliance, satisfaction, the level of 6MWT and NYHA functional classification.

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Efficacy and safety of beta-blockers and prolonged bronchodilators in patients with heart failure with coronary artery disease and moderate to severe COPD

European Heart Journal ◽

10.1093/ehjci/ehaa946.1156 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

V Evdokimov ◽

E Yushchuk ◽

A Evdokimova ◽

S Ivanova ◽

I Sadulaeva

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Clinical Condition ◽

Blood Pressure Monitoring ◽

Beta Blockers ◽

Control Group ◽

Efficacy And Safety ◽

Serious Adverse Events ◽

Severe Copd

Abstract Purpose To compare clinical efficacy and safety of various treatment regimens with the inclusion of beta-blockers, RAAS antagonists (ACE inhibitors or ARBs), prolonged bronchodilators (LABA, LAMA) in heart failure patients with CAD and COPD. Methods 385 patients (292 men and 93 women), aged 66.3±4.1 years, with CHF classes II to III (NYHA) combined with moderate to severe COPD (GOLD) and with LVEF less than 45% were randomized into nine groups: enalapril + LAMA (control group), nebivolol + enalapril + LAMA, nebivolol + losartan + LAMA, nebivolol + losartan + LABA, nebivolol + losartan + LAMA/LABA, carvedilol + enalapril + LAMA, carvedilol + losartan + LAMA, carvedilol + losartan + LABA, carvedilol + losartan + LAMA/LABA. Patients of all groups received complex CHF treatment comprising diuretics, nitrates, cardiac glycosides (if necessary). Clinical examination, TTE, 6-minute walk test (6MWT), 24-hour electrocardiogram and blood pressure monitoring, respiratory function test were assessed at baseline and after 6 months of treatment. The quality of life was evaluated by MYHFQ, SGRQ and mMRC scale. Results After 6 months of therapy the improvement of clinical condition and quality of life were marked in all groups. At the end of observation period there was a significant improvement of patients clinical condition, quality of life, reduction of mean CHF FC and dyspnea severity, increase of exercise tolerance, slowing of progression of CHF and COPD, improvement of the parameters of intracardiac hemodynamics, structural and functional parameters of the left and right heart (a decrease in the size of the atria, LV volumes and internal dimension at end-diastole and end-systole, cardiac index, LVMMI, an increase of LVEF, a significant decrease in systemic vascular resistance and the pulmonary hypertension grade, significant improvement in systolic and diastolic function of the ventricles, regression of pathological remodeling of the heart, reduction of heart rate, duration and frequency of myocardial ischemia episodes (including its “silent” form). The best results were obtained in groups using a beta-blocker (nebivolol or carvedilol), a RAAS antagonist, and a combination of long-acting bronchodilators (indacaterol and tiotropium) – group 5 and 9. It is worth noting that beta-blockers, LABA and LAMA were well tolerated in all observation groups and serious adverse events were absent. Conclusions The appointment of 3-generation beta-blockers to patients with CHF on the background of CAD and COPD can significantly increase the effectiveness of treatment and does not cause a deterioration in spirometry in patients with such cardiopulmonary pathology. In our opinion, the most important point in the appointment of beta blockers to patients with moderate to severe COPD is low start dose and slow titration of the dose at the beginning of the therapy. It is advisable to include in the complex therapy of such patients a combination of LABA and LAMA as a basic bronchodilator support. Funding Acknowledgement Type of funding source: None

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Long-term effectiveness of telephone-based health coaching for heart failure patients: A post-only randomised controlled trial

Journal of Telemedicine and Telecare ◽

10.1177/1357633x16668436 ◽

2016 ◽

Vol 23 (8) ◽

pp. 716-724 ◽

Cited By ~ 11

Author(s):

Michel Tiede ◽

Sarah Dwinger ◽

Lutz Herbarth ◽

Martin Härter ◽

Jörg Dirmaier

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Locus Of Control ◽

Controlled Trial ◽

Health Coaching ◽

Analysis Of Covariance ◽

Control Group ◽

Heart Failure Patients ◽

Health Related

Introduction The * Equal contributors. health-status of heart failure patients can be improved to some extent by disease self-management. One method of developing such skills is telephone-based health coaching. However, the effects of telephone-based health coaching remain inconclusive. The aim of this study was to evaluate the effects of telephone-based health coaching for people with heart failure. Methods A total sample of 7186 patients with various chronic diseases was randomly assigned to either the coaching or the control group. Then 184 patients with heart failure were selected by International Classification of Diseases (ICD)-10 code for subgroup analysis. Data were collected at 24 and 48 months after the beginning of the coaching. The primary outcome was change in quality of life. Secondary outcomes were changes in depression and anxiety, health-related control beliefs, control preference, health risk behaviour and health-related behaviours. Statistical analyses included a per-protocol evaluation, employing analysis of variance and analysis of covariance (ANCOVA) as well as Mann-Whitney U tests. Results Participants’ average age was 73 years (standard deviation (SD) = 9) and the majority were women (52.8%). In ANCOVA analyses there were no significant differences between groups for the change in quality of life (QoL). However, the coaching group reported a significantly higher level of physical activity ( p = 0.03), lower intake of non-prescribed drugs ( p = 0.04) and lower levels of stress ( p = 0.02) than the control group. Mann-Whitney U tests showed a different external locus of control ( p = 0.014), and higher reduction in unhealthy nutrition ( p = 0.019), physical inactivity ( p = 0.004) and stress ( p = 0.028). Discussion Our results suggest that telephone-based health coaching has no effect on QoL, anxiety and depression of heart failure patients, but helps in improving certain risk behaviours and changes the locus of control to be more externalised.

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SUPPORTING DEVICES IN THE TREATMENT OF CHRONIC HEART FAILURE IN ELDERLY AND OLD PATIENTS

Pharmacy Formulas ◽

10.17816/phf41944 ◽

2020 ◽

Vol 2 (3) ◽

pp. 40-57

Author(s):

Gennadiy Hubulava ◽

Kirill L. Kozlov ◽

Andrey N. Bogomolov ◽

Aleksey Volkov ◽

Viktor N. Fedorets ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Clinical Practice ◽

Chronic Heart Failure ◽

Severe Heart Failure ◽

Circulatory Support ◽

Old Patients ◽

Western Countries ◽

Surgical Methods

Chronic heart failure (CHF) is a widespread disease associated with high rates of disability and mortality, as well as a decrease in the quality of life. Moreover, the vast majority of patients are elderly and senile. Modern surgical methods of treating heart failure are able to increase the duration and quality of life of such patients, however, the need far exceeds the volume of this care, and some highly effective methods common in Western countries are still not used in Russian clinical practice. Elderly age is a risk factor for the development of senile asthenia (frailty) and concomitant pathology. Large abdominal surgery is often contraindicated for patients with signs of senile asthenia, and the method of choice in patients with severe heart failure is the implantation of devices for long-term mechanical circulatory support (LT-MCS). After implantation of LT-MCS, a regression of signs of senile asthenia may be observed. The topic of an integrated approach to non-drug treatment of heart failure in elderly and senile patients in Russia has not been studied enough. In particular, the implantation of LT-MCS is not used in Russian clinical practice, while in many Western countries for many years it has been the main and most effective treatment for severe heart failure. Systematization of the available up-to-date information on this topic could help increase the duration and quality of life of patients with severe heart failure.

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