Outpatient Costs of Medications for Patients with Chronic Heart Failure

2002 ◽  
Vol 11 (5) ◽  
pp. 474-478 ◽  
Author(s):  
Leslie C. Hussey ◽  
Sonya Hardin ◽  
Christopher Blanchette
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Web Sites ◽  
Heart Association ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Ability To Pay ◽  
New York Heart Association

• Background The outpatient costs of medications prescribed for chronic heart failure are high and are often borne by individual patients. Lack of financial resources may force noncompliance with use of medications. • Objective To compare the outpatient costs of medications for patients with different New York Heart Association classifications of chronic heart failure. • Methods The charts of 138 patients with chronic heart failure were reviewed retrospectively. Outpatient costs of medications were obtained from the Web sites of commercial pharmacies. Medications were classified by type according to the system of the American Heart Association. A mean cost for each classification of medication was used for analysis. • Results The overall mean monthly cost of medications for chronic heart failure was $438. Patients with class II and class III chronic heart failure had the highest costs: $541 and $514, respectively. Analysis of variance indicated that the differences in monthly costs of medications between the patients with the 4 stages of chronic heart failure were significant (F = 4.86, P = .003). A post hoc Scheffé test revealed significant differences in costs between patients with class I and patients with class II heart failure (P=.02) and between patients with class I and those with class III heart failure (P=.02). • Conclusions The outpatient costs of medications for chronic heart failure are significant. Ability to pay for prescribed medications must be determined. Healthcare professionals must maintain an awareness of the costs of medications and patients’ ability to pay.

Serum metabolic characteristics and biomarkers of early-stage heart failure

2020 ◽  
Vol 14 (2) ◽  
pp. 119-130
Author(s):  
Siqi Guo ◽  
Jing Kong ◽  
Danya Zhou ◽  
Minchao Lai ◽  
Yirun Chen ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Early Stage ◽  
Heart Association ◽  
Class Ii ◽  
Class I ◽  
Metabolic Characteristics ◽  
Diagnostic Potential ◽  
Association Class ◽  
New York Heart Association

Aim: We aimed to identify metabolic characteristics of early-stage heart failure (HF) and related biomarkers. Patients & methods: One hundred and forty-three patients with New York Heart Association class I–IV HF and 34 healthy controls were recruited. Serum metabolic characteristics of class I HF were analyzed and compared with those of class II–IV HF. Potential biomarkers of class I HF with normal N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level were screened and validated in additional 72 subjects (46 class I patients and 26 controls). Results & conclusion: Eleven metabolites were found disturbed in class I HF, and five of which were also disturbed in class II–IV HF. Glutamine and tyrosine showed high value to identify class I HF with normal NT-proBNP level. The diagnostic potential of glutamine was partially confirmed in the validate set, holding a promise to detect early HF with normal NT-proBNP level.

scholarly journals Remote monitoring of chronic heart failure patients: invasive versus non-invasive tools for optimising patient management

2019 ◽  
Vol 28 (1) ◽  
pp. 3-13 ◽  
Author(s):  
J. F. Veenis ◽  
J. J. Brugts
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Remote Monitoring ◽  
Heart Association ◽  
The United States ◽  
Pharmacological Therapy ◽  
Functional Class ◽  
Class Iii ◽  
Additional Tool

AbstractExacerbations of chronic heart failure (HF) with the necessity for hospitalisation impact hospital resources significantly. Despite all of the achievements in medical management and non-pharmacological therapy that improve the outcome in HF, new strategies are needed to prevent HF-related hospitalisations by keeping stable HF patients out of the hospital and focusing resources on unstable HF patients. Remote monitoring of these patients could provide the physicians with an additional tool to intervene adequately and promptly. Results of telemonitoring to date are inconsistent, especially those of telemonitoring with traditional non-haemodynamic parameters. Recently, the CardioMEMS device (Abbott Inc., Atlanta, GA, USA), an implantable haemodynamic remote monitoring sensor, has shown promising results in preventing HF-related hospitalisations in chronic HF patients hospitalised in the previous year and in New York Heart Association functional class III in the United States. This review provides an overview of the available evidence on remote monitoring in chronic HF patients and future perspectives for the efficacy and cost-effectiveness of these strategies.

Abstract 2848: Medication Knowledge And Assistance In Older Chronic Heart Failure Patients.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Robyn Gallagher ◽  
Judith Donoghue ◽  
Lynn Chenoweth ◽  
Jane Stein-Parbury
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Self Efficacy ◽  
Heart Association ◽  
Post Discharge ◽  
Medication Knowledge ◽  
Moderate Heart Failure ◽  
Association Class ◽  
New York Heart Association

Medication knowledge and assistance in older chronic heart failure (CHF) patients. Medication adherence is central to the optimal management of CHF. Little is known about older patients’ knowledge of their medications or the factors that contribute to this knowledge. Aim: To describe and identify the predictors of medication knowledge in older CHF patients. Method: Subjects ( n = 62) aged over 55 years with moderate heart failure (New York Heart Association Class II and III) who identified as self-managing were recruited from hospital or rehabilitation. Interviews occurred at home four weeks post-discharge using a medication checklist and the Self-Efficacy in Chronic Illness Scale (Lorig et al, 2001). Multiple regression analysis determined the predictors of medication knowledge. Results: Patients were aged mean 78.4 years (sd 8.54 years), mostly male (57%) and had an average 8 (median, range 3–22) medications to take daily, of which 6 (median, range 3–14) were for CHF. Most managed their own medications (54%) but more than a quarter (28%) were assisted by reminding, dispensing and supervision. Compliance with medications was high (84%), although only half (53%) knew the name, main purpose and side effect of their medications. Patients with better self-efficacy (β = 2.88) and no help with medication (β = -21.05) had better medication knowledge (model F = 13.6, p = .000, R = .61, r 2 = .37). Conclusion: Older CHF patients have poor knowledge of their medications, which may be improved by promoting overall self-efficacy for disease management. Less knowledgeable patients received appropriate assistance with medications, but the consequence may be less knowledge and thus warrants further investigation.

scholarly journals Utility Estimates for Decision–Analytic Modeling in Chronic Heart Failure—Health States Based on New York Heart Association Classes and Number of Rehospitalizations

2009 ◽  
Vol 12 (1) ◽  
pp. 185-187 ◽  
Author(s):  
Alexander Göhler ◽  
Benjamin P. Geisler ◽  
Jennifer M. Manne ◽  
Mikhail Kosiborod ◽  
Zefeng Zhang ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Heart Association ◽  
Health States ◽  
Analytic Modeling ◽  
New York Heart Association

scholarly journals Remote Hemodynamic‐Guided Therapy of Patients With Recurrent Heart Failure Following Cardiac Resynchronization Therapy

2021 ◽  
Author(s):  
Niraj Varma ◽  
Robert C. Bourge ◽  
Lynne Warner Stevenson ◽  
Maria Rosa Costanzo ◽  
David Shavelle ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Cardiac Resynchronization Therapy ◽  
Area Under The Curve ◽  
Heart Association ◽  
Cardiac Resynchronization ◽  
Class Iii ◽  
Resynchronization Therapy ◽  
Heart Failure Questionnaire ◽  
New York Heart Association

Background Patients with recurring heart failure (HF) following cardiac resynchronization therapy fare poorly. Their management is undecided. We tested remote hemodynamic‐guided pharmacotherapy. Methods and Results We evaluated cardiac resynchronization therapy subjects included in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in New York Heart Association Class III Heart Failure Patients) trial, which randomized patients with persistent New York Heart Association Class III symptoms and ≥1 HF hospitalization in the previous 12 months to remotely managed pulmonary artery (PA) pressure‐guided management (treatment) or usual HF care (control). Diuretics and/or vasodilators were adjusted conventionally in control and included remote PA pressure information in treatment. Annualized HF hospitalization rates, changes in PA pressures over time (analyzed by area under the curve), changes in medications, and quality of life (Minnesota Living with Heart Failure Questionnaire scores) were assessed. Patients who had cardiac resynchronization therapy (n=190, median implant duration 755 days) at enrollment had poor hemodynamic function (cardiac index 2.00±0.59 L/min per m 2 ), high comorbidity burden (67% had secondary pulmonary hypertension, 61% had estimated glomerular filtration rate <60 mL/min per 1.73 m 2 ), and poor Minnesota Living with Heart Failure Questionnaire scores (57±24). During 18 months randomized follow‐up, HF hospitalizations were 30% lower in treatment (n=91, 62 events, 0.46 events/patient‐year) versus control patients (n=99, 93 events, 0.68 events/patient‐year) (hazard ratio, 0.70; 95% CI, 0.51–0.96; P =0.028). Treatment patients had more medication up‐/down‐titrations (847 versus 346 in control, P <0.001), mean PA pressure reduction (area under the curve −413.2±123.5 versus 60.1±88.0 in control, P =0.002), and quality of life improvement (Minnesota Living with Heart Failure Questionnaire decreased −13.5±23 versus −4.9±24.8 in control, P =0.006). Conclusions Remote hemodynamic‐guided adjustment of medical therapies decreased PA pressures and the burden of HF symptoms and hospitalizations in patients with recurring Class III HF and hospitalizations, beyond the effect of cardiac resynchronization therapy. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00531661.

scholarly journals Evaluation of the influence of the therapy with fosinopril and zofenopril on the regulatory-adaptive status of patients with diastolic chronic heart failure

2019 ◽  
Vol 10 (4) ◽  
pp. 23-28
Author(s):  
Svetlana N. Nedvetskaya ◽  
Vitalii G. Tregubov ◽  
Iosif Z. Shubitidze ◽  
Vladimir M. Pokrovskiy
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Subjective Evaluation ◽  
Heart Association ◽  
Functional Class ◽  
New York Heart Association

Aim. Еvaluate the influence of combination therapy with fosinopril or zofenopril on the regulatory-adaptive status (RAS) of patients with diastolic chronic heart failure (CHF). Material and methods. The study includes 80 patients with CHF I-II functional class according to the classification of the New York heart Association with left ventricle ejection fraction ≥50% because of hypertensive disease (HD) of III stage, who were randomized into two groups for treatment with fosinopril (14.7±4.2 mg/day, n=40) or zofenopril (22.5±7.5 mg/day, n=40). As part of combination pharmacotherapy, patients were included nebivolol (7.1±2.0 mg/day and 6.8±1.9 mg/day), in the presence of indications, atorvastatin and acetylsalicylic acid in the intestinal shell were prescribed. Initially and after six months, the following was done: a quantitative evaluation of the RAS (by cardio-respiratory synchronism test), echocardiography, tredmil-test, six-minute walking test, determination of the N-terminal precursor of the natriuretic brain peptide level in blood plasma and subjective evaluation of quality of life. Results. Therapy, using fosinopril, in comparison with zofenopril, more improved RAS (by 66.5%, p

scholarly journals New biochemical markers in chronic heart failure

2001 ◽  
Vol 7 (4-5) ◽  
pp. 697-706
Author(s):  
E. M. El Bindary ◽  
A. Z. Darwish
Keyword(s):  
Heart Failure ◽  
New York ◽  
Chronic Heart Failure ◽  
Heart Association ◽  
University Hospital ◽  
Tnf Alpha ◽  
Necrosis Factor Alpha ◽  
New York Heart Association ◽  
Neuroendocrine Activation ◽  
Plasma Leptin

We investigated the plasma levels of tumour necrosis factor-alpha [TNF-alpha], leptin and insulin, and their relation to body mass index [BMI] in 80 male patients who presented with chronic heart failure [mean age: 47 +/- 4 years] at Tanta University Hospital. Plasma leptin, TNF-alpha and insulin were significantly increased and BMI significantly decreased in New York Heart Association classes III and IV patients. TNF-alpha, leptin and insulin were positively correlated, and TNF-alpha and BMI and leptin and BMI were negatively correlated in stages III and IV of heart failure. We conclude that cytokine neuroendocrine activation may form part of advanced stage heart failure. It may also be responsible for worsening cachexia, and can be used as a marker to determine disease severity.

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