Contemporary Heart Failure Treatment Based on Improved Knowledge and Personalized Care of Comorbidities

2019 ◽  
pp. 1565-1579
Author(s):  
Kostas Giokas ◽  
Charalampos Tsirmpas ◽  
Athanasios Anastasiou ◽  
Dimitra Iliopoulou ◽  
Vassilia Costarides ◽  
...  

Chronic diseases are the leading cause of mortality and morbidity. A significant contribution to the burden of chronic diseases is the concurrence of co-morbidities. Heart failure (HF) is a complex, chronic medical condition frequently associated with co-morbidities. The current care approach for HF patients with co-morbidities is neither capable to deliver personalised care nor to halt the on-going increase of its socio-economic burden. Our approach aims to improve the complete care process for HF patients and related co-morbidities to improve outcome and quality of life. This will be achieved by the proposed standardised yet personalised patient-oriented ICT system that supports evidence-based clinical decision making as well as interaction and communication between all stakeholders with focus on the patients and their relatives to improve self-management. We propose that such a system should be build upon a novel European-wide data standard for clinical input and outcome and that it should facilitate decision making and outcome tracking by new collective intelligence algorithms.

Author(s):  
Kostas Giokas ◽  
Charalampos Tsirmpas ◽  
Athanasios Anastasiou ◽  
Dimitra Iliopoulou ◽  
Vassilia Costarides ◽  
...  

Chronic diseases are the leading cause of mortality and morbidity. A significant contribution to the burden of chronic diseases is the concurrence of co-morbidities. Heart failure (HF) is a complex, chronic medical condition frequently associated with co-morbidities. The current care approach for HF patients with co-morbidities is neither capable to deliver personalised care nor to halt the on-going increase of its socio-economic burden. Our approach aims to improve the complete care process for HF patients and related co-morbidities to improve outcome and quality of life. This will be achieved by the proposed standardised yet personalised patient-oriented ICT system that supports evidence-based clinical decision making as well as interaction and communication between all stakeholders with focus on the patients and their relatives to improve self-management. We propose that such a system should be build upon a novel European-wide data standard for clinical input and outcome and that it should facilitate decision making and outcome tracking by new collective intelligence algorithms.


2018 ◽  
Vol 10 (3) ◽  
pp. e26-e26 ◽  
Author(s):  
Paul Taylor ◽  
Miriam J Johnson ◽  
Dawn Wendy Dowding

ObjectivesTo improve the ability of clinical staff to recognise end of life in hospital inpatients dying as a result of cancer and heart failure, and to generate new hypotheses for further research.MethodsThis mixed-methods study used decision theory as a theoretical basis. It involved a parallel databases-convergent design, incorporating findings from previously published research, with equal priority to study groups and synthesis by triangulation. The individual arms were (1) a retrospective cohort study of 102 patients with cancer and 81 patients with heart failure in an acute trust in the North of England, and(2) a semistructured interview study of 19 healthcare professionals caring for the same patient groups.ResultsThe synthesis of findings demonstrated areas of agreement, partial agreement, silence and dissonance when comparing the cohort findings with the interview findings. Trajectories of change are identified as associated with poor prognosis in both approaches, but based on different parameters. Management of patients has a significant impact on decision-making. The decision process requires repeated, iterative assessments and may benefit from a multidisciplinary approach. Uncertainty is a defining characteristic of the overall process, and objective parameters only have a limited role in predicting end of life.ConclusionsThe role of uncertainty is important as a trigger for discussions and a defined stage in a patient’s illness journey. This is consistent with current approaches to recognising irreversible deterioration in those with serious illness. This study contributes ongoing evidence that these concepts are vital for decision-making.


Author(s):  
Asiful Islam

This thesis will guide health communities to better understand the clinical decision-making process that physicians from rural Ontario undergo when considering whether to prescribe medical cannabis to patients for their medical condition. Very few studies have been conducted which examine the perspectives of physicians on medical cannabis, especially in rural areas, and these studies have found that most physicians are skeptical towards medical cannabis. This skeptical perspective of physicians has complicated the clinical decision-making process as “recent changes in media reports and changing trends in social media propose a change in the attitudes towards cannabis (Zolotov et al., 2018, p.5).” Physicians practicing in rural Ontario are currently being recruited to participate in semi-structured interviews to explore the issues which they prioritize the most. Once completed, the findings from this study will identify common themes and trends that could help influence change in physician practice and healthcare policy.


2013 ◽  
Vol 61 (10) ◽  
pp. E826 ◽  
Author(s):  
Siddique Abbasi ◽  
Andrew Ertel ◽  
Ravi Shah ◽  
Tomas Neilan ◽  
Bobby Heydari ◽  
...  

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