scholarly journals Efecto de un programa de paciente experto en insuficiencia cardiaca

2019 ◽  
Vol 19 (1) ◽  
pp. 479-506
Author(s):  
Diana Marcela AChury ◽  
Laura Restrepo ◽  
Kamila Munar ◽  
Indira Rodriguez ◽  
Maria Camila Cely ◽  
...  
Keyword(s):  
Heart Failure ◽  
Descriptive Analysis ◽  
Cost Effective ◽  
Health Condition ◽  
Adherence To Treatment ◽  
Expert Patient ◽  
Patients With Heart Failure ◽  
Insuficiencia Cardiaca ◽  
Level Of Knowledge ◽  
Level Institution

Introducción: Una estrategia que ha mostrado ser efectiva para promover el autocuidado en los pacientes con falla cardiaca es la formación de diadas y grupos que brinden apoyo de pares para favorecer el logro de metas individuales.Objetivo general: Determinar el efecto de un programa de paciente experto en falla cardiaca en los conocimientos relacionados con la adherencia al tratamiento y en la satisfacción. Método: Se realizó un estudio piloto descriptivo de corte transversal en pacientes con diagnósticos de falla cardiaca en una institución de cuarto nivel. El tamaño de la muestra correspondió a toda la población con los criterios de restricción (N: 20 sujetos). Se implementó un programa de paciente experto durante 6 meses y se midieron los desenlaces de nivel de conocimientos y satisfacción. Para la recolección de la información se utilizó un test de conocimientos sobre adherencia al tratamiento y una encuesta de satisfacción. La información se procesó a través del programa IBM SPSS Statistics 23.0, y se realizó un análisis descriptivo con distribución de frecuencias absolutas y relativas. Resultados: Más del 95% de los pacientes mostró mejoría significativa en el nivel de conocimientos y el 85% refirió el nivel de satisfacción global más alto (muy satisfechos), reflejado en la dimensión de fidelización y efectividad. Conclusiones: El programa del paciente experto en insuficiencia cardiaca se constituye en una intervención costo-efectiva que proporciona capacidades para ayudar a otros pacientes a adquirir autoconfianza y habilidades en el manejo de su condición de salud.  Introduction: One of the strategies that has shown improvement in self-care for patients with heart failure is the formation of dyads and groups to provide peer support and achieve individual goals. General objective: To determine the effect of an expert patient program on heart failure related to the knowledge about adherence to treatment and satisfaction.Method: A sectional-descriptive pilot study was conducted in patients with heart failure diagnoses in a fourth-level institution. The sample size represents the entire population with the restriction criteria (N: 20 subjects). An expert patient program was implemented for 6 months and the measured outcomes were level of knowledge and satisfaction. Data was gathered from a knowledge test on adherence to treatment and a satisfaction poll. Information was processed with IBM SPSS Statistics 23.0. The distribution of absolute and relative frequencies was performed by descriptive analysis. Results: More than 95% of patients showed improvement in the level of knowledge and 85% reported a high global level of satisfaction (very satisfied), reflected in the dimension of loyalty and effectiveness. Conclusions: The expert patient in heart failure program is a cost-effective intervention, which provides capabilities to help other patients gain self-confidence and skills to manage their health condition.

scholarly journals Telecuidado como uma estratégia de saúde para a adesão do paciente com insuficiência cardíaca – revisão integrative

2020 ◽  
Vol 19 (2) ◽  
pp. 591-639
Author(s):  
Maria Auxiliadora Ribeiro de Jesus Guerreiro ◽  
Selma Petra Chaves Sá Guerreiro ◽  
Kyra Vianna Alochio ◽  
Martha Tudrej Sattler Ribeiro
Keyword(s):  
Heart Failure ◽  
Signs And Symptoms ◽  
Adherence To Treatment ◽  
Pharmacological Treatments ◽  
Treatment Results ◽  
Monitoring Strategies ◽  
Number Of Patients ◽  
Patients With Heart Failure ◽  
Insuficiencia Cardiaca ◽  
Tele Monitoring

Objetivo: Identificar estrategias de telecuidado para pacientes con insuficiencia cardíaca que colaboran para la adhesión al tratamiento.Material y Método: Revisión integrativa de la literatura realizada en las bases de datos CINAHL, PubMed, Scielo y LILACS. La elaboración del problema fue guiada por la estrategia PICO que originó la siguiente pregunta: ¿Cuáles son las estrategias del telecuidado para los pacientes con insuficiencia cardíaca que contribuyen a su adhesión al tratamiento?Resultados: Dieciséis artículos atendieron a los criterios definidos por el estudio y por lo tanto, participaron del análisis de esta revisión.Conclusión: El telecuidado posibilita el acompañamiento de un número mayor de pacientes, contribuyendo al control de signos y síntomas de la insuficiencia cardiaca. Favorece la optimización de los tratamientos farmacológico y no farmacológico disminuyendo tasas de re-hospitalización y mortalidad. Objective: Identify tele-monitoring strategies for patients with heart failure who collaborate for adherence when it comes to treatment.Material and Method: Integrative review of the literature carried out in the databases CINAHL, PubMed, Scielo and LILACS. The elaboration of the problem was guided by the PICO strategy that gave rise to the following question: "What are the tele-monitoring strategies for patients with heart failure that contribute to their adherence to treatment?".Results: Sixteen articles met the criteria defined by the study and, therefore, participated in the analysis of this review.Conclusion: Tele-monitoring allows the monitoring of a larger number of patients, contributing to the control of signs and symptoms of heart failure. Also, It favors the optimization of pharmacological and non-pharmacological treatments, reducing rates of rehospitalization and mortality.

scholarly journals Evidências científicas sobre a qualidade de vida dos pacientes com insuficiência cardíaca: revisão integrativa*

2019 ◽  
Vol 82 (20) ◽  
Author(s):  
Flávia Ribeiro do Carmo ◽  
Harriet Bárbara Maruxo ◽  
Willian Alves dos Santos
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Scientific Evidence ◽  
Physical Activities ◽  
Microsoft Excel ◽  
Exclusion Criteria ◽  
Patients With Heart Failure ◽  
Insuficiencia Cardiaca ◽  
Main Factors

Objetiva-se identificar evidências científicas sobre a qualidade de vida em pacientes diagnosticados com insuficiênciacardíaca. Revisão integrativa realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde(LILACS), Base de Dados de Enfermagem (BDENF) e Sistema Online de Busca e Análise de Literatura Médica (MEDLINE)com a seguinte questão norteadora: Como a insuficiência cardíaca interfere na qualidade de vida dos pacientescardiológicos? Foi utilizada a estratégia PICO com recorte temporal de 2011 a 2016, nos idiomas português, inglês eespanhol. As informações foram tabuladas em programa Microsoft Excel® e processadas a partir de estratégia: médiaaritmética descritiva simples, frequência absoluta e relativa. Encontrou-se 712 artigos na sua totalidade, após aplicaçãodos critérios de inclusão e exclusão foram selecionados 17 artigos científicos avaliados a partir da categoria: os principaisfatores que comprometem a qualidade de vida dos pacientes com insuficiência cardíaca. Conclui-se que os pacientes cominsuficiência cardíaca apresentam intolerância à realização de atividades físicas e têm seu sono prejudicado por conta dadispneia e fadiga, sintomas que contribuem para o declínio da qualidade de vida.Palavras-chave: Insuficiência Cardíaca; Qualidade de Vida; Enfermagem. ABSTRACTThe aim is to identify scientific evidence on the quality of life in patients diagnosed with heart failure. Integrativereview carried out in the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dadosde Enfermagem (BDENF) e Sistema Online de Busca e Análise de Literatura Médica (MEDLINE) databases withthe question: How does heart failure interfere with the quality of life of cardiology patients? The PICO strategywith time cut from 2011 to 2016 was used in Portuguese, English and Spanish. The information was tabulated inMicrosoft Excel® program and processed from strategy: simple descriptive arithmetic mean, absolute and relativefrequency. It found 712 articles in their totality, after applying the inclusion and exclusion criteria, were selected17 scientific articles evaluated from the category: the main factors that compromise the quality of life of patientswith heart failure. It concludes that the patients with heart failure are intolerant to physical activities and sleepimpaired due to dyspnea and fatigue, such symptoms that contribute to the decline of quality of life.Keywords: Heart failure; Quality of life; Nursing.

scholarly journals Rationale of specialized medical care for patients with chronic heart failure in the Russian Federation

2020 ◽  
Vol 1 (3) ◽  
pp. 44-53
Author(s):  
I. V. Fomin ◽  
N. G. Vinogradova
Keyword(s):  
Heart Failure ◽  
Medical Care ◽  
Clinical Severity ◽  
Adherence To Treatment ◽  
Group I ◽  
Patients With Heart Failure ◽  
Group Ii ◽  
Overall Mortality ◽  
Group 1

Objectives: to determine the causes of ineffective observation and poor prognosis in patients undergoing ADHF, in real clinical practice and to consider the basics of the formation of specialized medical care for patients with heart failure (HF).Materials and methods: the study was conducted based on the City Center for the treatment of heart failure (center HF), N. Novgorod. The study consistently included 942 patients with heart failure (HF) at the age of 18 years and older who underwent ADHF and received inpatient treatment in center HF between March 4, 2016 and March 3, 2017. Based on the decisions of patients to continue outpatient monitoring in center HF, two groups of patients were distinguished: patients who continued to be monitored in center HF (group I, n = 510) and patients who continued to be monitored in outpatient clinics at the place of residence (group II, n = 432). The assessment of adherence to treatment, overall mortality, survival and re-admission to a depth of two years of observation was carried out. Statistical data processing was performed using Statistica 7.0 for Windows and the software package R.Results: all patients in the study groups had high comorbidity. Group 2 patients turned out to be statistically significantly older, more often had III functional class (FC) HF, lower the baseline test score of 6-minute walk, and higher the baseline clinical assessment scale. After 2 years of follow-up in group II, there was a significant deterioration in adherence to basic therapy of HF compared with group I. According to the results of multifactorial proportional risk Cox models, it was shown that observation of patients in the group 1 is an independent factor increasing the risk of overall mortality by 2.8 times by the end of the second year of observation. Survival after two years of follow-up was: in group I — 89.8 %, and in group II — 70.1 % of patients (OR = 0.3, 95 % CI 0.2 – 0.4; p1/2 < 0.001). After two years of follow-up, the proportion of re-hospitalized patients in group II was greater (78.0 % of patients) versus group 1 (50.6 % of patients, OR = 3.5, 95 % CI 2.6 – 4.6; p1/2 <0.001). The independent risk of re-hospitalization according to multinominal logit regression was 3.4 times higher in group II and 2.4 times for III – IV FC HF. Conclusions: the inclusion of patients with HF in the system of specialized medical care improves adherence to treatment, prognosis of life and reduces the risk of repeated hospitalizations. Patients of an older age and with an initially greater clinical severity refused specialized supervision in center HF.

scholarly journals Cost-Effectiveness Evaluation of Add-on Empagliflozin in Patients With Heart Failure and a Reduced Ejection Fraction From the Healthcare System's Perspective in the Asia-Pacific Region

2021 ◽  
Vol 8 ◽  
Author(s):  
Chia-Te Liao ◽  
Chun-Ting Yang ◽  
Fang-Hsiu Kuo ◽  
Mei-Chuan Lee ◽  
Wei-Ting Chang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Ejection Fraction ◽  
Standard Therapy ◽  
Cost Effective ◽  
Asia Pacific ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Cost ◽  
Country Specific

Background: EMPEROR-Reduced trial provides promising evidence on the efficacy of empagliflozin adding to the standard treatment in patients with heart failure and reduced ejection fraction (HFrEF). This study aimed to investigate the cost-effectiveness of add-on empagliflozin vs. standard therapy alone in HFrEF from the perspective of the Asia-Pacific healthcare systems.Methods: A Markov model was constructed to simulate HFrEF patients and to project the lifetime direct medical costs and quality-adjusted life years (QALY) of both therapies. Transitional probabilities were derived from the EMPEROR-Reduced trial. Country-specific costs and utilities were extracted from published resources. Incremental cost-effectiveness ratio (ICER) against willingness to pay (WTP) threshold was used to examine the cost-effectiveness. A series of sensitivity analyses was performed to ensure the robustness of the results.Results: The ICERs of add-on empagliflozin vs. standard therapy alone in HFrEF were US$20,508, US$24,046, US$8,846, US$53,791, US$21,543, and US$20,982 per QALY gained in Taiwan, Japan, South Korea, Singapore, Thailand, and Australia, respectively. Across these countries, the probabilities of being cost-effective for using add-on empagliflozin under the WTP threshold of 3-times country-specific gross domestic product per capita were 93.7% in Taiwan, 95.6% in Japan, 96.3% in South Korea, 94.2% Singapore, 51.9% in Thailand, and 95.9% in Australia. The probabilities were reduced when shortening the time horizon, assuming the same cardiovascular mortality for both treatments, and setting lower WTP thresholds.Conclusion: Adding empagliflozin to HFrEF treatment is expected to be a cost-effective option among the Asia-Pacific countries. The cost-effectiveness is influenced by the WTP thresholds of different countries.

scholarly journals Advanced circulatory support: artificial heart use in patients with heart failure / Suporte circulatório avançado: uso do coração artificial em pacientes com Insuficiência cardíaca

2020 ◽  
Vol 3 (5) ◽  
pp. 12214-12237
Author(s):  
Luiza Miranda Marinho de Paula ◽  
Bruna Xisto Mesquita de Oliveira ◽  
Eduarda Viana Maia Sutana ◽  
Eduardo Paulo Fonseca Silva ◽  
Gabriela Bussad Pires ◽  
...  
Keyword(s):  
Heart Failure ◽  
Artificial Heart ◽  
Circulatory Support ◽  
Patients With Heart Failure ◽  
Insuficiencia Cardiaca

scholarly journals Cost–utility analysis of learning and coping versus standard education in cardiac rehabilitation: a randomised controlled trial with 3 years of follow-up

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001184
Author(s):  
Nasrin Tayyari Dehbarez ◽  
Camilla Palmhøj Nielsen ◽  
Bettine Wulff Risør ◽  
Claus Vinther Nielsen ◽  
Vibeke Lynggaard
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Cardiac Rehabilitation ◽  
Controlled Trial ◽  
Cost Effective ◽  
Cost Utility ◽  
Small Sample ◽  
Life Years ◽  
Patients With Heart Failure ◽  
And Coping

ObjectivesTo enhance adherence to cardiac rehabilitation (CR), a patient education programme called ‘learning and coping’ (LC-programme) was implemented in three hospitals in Denmark. The aim of this study was to investigate the cost–utility of the LC-programme compared with the standard CR-programme.Methods825 patients with ischaemic heart disease or heart failure were randomised to the LC-programme or the standard CR-programme and were followed for 3 years.A societal cost perspective was applied and quality-adjusted life years (QALY) were based on SF-6D measurements. Multiple imputation technique was used to handle missing data on the SF-6D. The statistical analyses were based on means and bootstrapped SEs. Regression framework was employed to estimate the net benefit and to illustrate cost-effectiveness acceptability curves.ResultsNo statistically significant differences were found between the two programmes in total societal costs (4353 Euros; 95% CI –3828 to 12 533) or in QALY (–0.006; 95% CI –0.053 to 0.042). At a threshold of 40 000 Euros, the LC-programme was found to be cost-effective at 15% probability; however, for patients with heart failure, due to increased cost savings, the probability of cost-effectiveness increased to 91%.ConclusionsWhile the LC-programme did not appear to be cost-effective in CR, important heterogeneity was noted for subgroups of patients. The LC-programme was demonstrated to increase adherence to the rehabilitation programme and to be cost-effective among patients with heart failure. However, further research is needed to study the dynamic value of heterogeneity due to the small sample size in this subgroup.

Clinical characteristics and sociodemográficas of patients acometidos for cardiac insufficience

2010 ◽  
Vol 4 (4) ◽  
pp. 1711
Author(s):  
Francisca Elisângela Teixeira Lima ◽  
Danielle Diógenes Nunes ◽  
Débora Lima Freitas ◽  
Ires Lopes Custódio ◽  
Francisca Lígia Medeiros Martins Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Health Education ◽  
Family Income ◽  
Cardiovascular Complications ◽  
Patients With Heart Failure ◽  
Insuficiencia Cardiaca ◽  
Factores De Riesgo ◽  
Hereditary Factors ◽  
Nursing Health

ABSTRACTObjective: to evaluate the epidemiological aspects of patients with Heart Failure (HF) and identify the risk factors in patients with HF. Method: this is about a descriptive study, quantitative, performed in a hospital from Fortaleza-CE. The population was composed of patients hospitalized with HF, the sample comprising 100 patients who met the criteria for inclusion. Data were collected in records and interview. Approved by the Ethics Committee n.º 514/2008. Results: prominent mention as sociodemographic characteristics are: male (63%), age> 60 years (43%), presence of hereditary factors (48%), married (67%), retired (42%) and family income < 1 minimum wage (70%). Modifiable risk factors identified: hypertension (61%), diabetes (22%), overweight (40%), hyperlipidemia (18%), sedentary (82%) smokers (11%) and consumers of alcohol (15%). Conclusion: as we conclude, knowing the profile of the population that carry the HF is favorable to develop strategies for health education to prevent cardiovascular complications in people with higher number of risk factors. Descriptors: health profile; cardiovascular diseases; heart failure; nursing; health education; health promotion. RESUMOObjetivo: levantar as características sociodemográficas dos pacientes portadores de insuficiência cardíaca (IC) e identificar os fatores de risco modificáveis nos pacientes portadores de IC. Método: estudo descritivo, quantitativo, desenvolvido em hospital terciário de Fortaleza-CE. A população foi constituída por pacientes com IC hospitalizados, com amostra de 100 pacientes. Os dados foram coletados nos prontuários e em entrevista. Aprovado pelo comitê de ética sob parecer n.º 514/2008. Resultados: predominaram como características sociodemográficas: sexo masculino (63%); idade > 60 anos (43%); presença de fatores hereditários (48%); casados (67%); aposentados (42%) e com renda familiar < 1 salário mínimo (70%). Fatores de risco modificáveis detectados: hipertensão (61%); diabetes (22%); sobrepeso (40%); dislipidemia (18%); sedentários (82%); tabagistas (11%) e etilista (15%). Conclusão: conclui-se que conhecer o perfil da população portadora de IC é favorável para desenvolver estratégias de educação em saúde a fim de prevenir complicações cardiovasculares nas populações com fatores de risco. Descritores: perfil de saúde; doenças cardiovasculares; insuficiência cardíaca; enfermagem; educação em saúde; promoção da saúde.RESUMEN Objetivo: evaluar los aspectos epidemiológicos de los pacientes con insuficiencia cardiaca (IC) y identificar los factores de riesgo en pacientes con IC. Método: estudio descriptivo, cuantitativo, desarrollado en hospital terciario, Fortaleza-CE. La población se compone de los pacientes hospitalizados con IC, la muestra de 100 pacientes. Datos fueron recolectados en los registros y entrevista. Aprobado por el Comitê de Ética nº 514/2008. Resultados: prominente mencionar características sociodemográficas como: sexo masculino (63%), edad > 60 años (43%), presencia de factores hereditarios (48%), casadas (67%), jubilados (42%) y los ingresos de la familia

scholarly journals ANÁLISE DAS CARACTERÍSTICAS FUNCIONAIS PULMONARES E SUAS REPERCUSSÕES EM PACIENTES COM INSUFICIÊNCIA CARDÍACA

2018 ◽  
Vol 3 (2) ◽  
pp. 12
Author(s):  
Renata Gomes Chaves ◽  
Camila Barbosa Araújo ◽  
Maria Bruna Madeiro da Silva ◽  
Natalia Jacinto de Almeida Leal ◽  
Clarissa Bentes de Araújo Magalhães ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Respiratory Muscle ◽  
Field Research ◽  
Clinical Syndrome ◽  
University Hospital ◽  
Mean Values ◽  
Patients With Heart Failure ◽  
Insuficiencia Cardiaca ◽  
Functional Classes

A insuficiência cardíaca (IC) é uma síndrome clínica sistêmica complexa em que a disfunção cardíaca ocasiona suprimento sanguíneo inadequado para atender as necessidades metabólicas dos tecidos. Objetivou-se analisar as características funcionais pulmonares e suas repercussões em pacientes com insuficiência cardíaca de um Hospital Universitário da cidade de Fortaleza/CE. Pesquisa de campo, seccional, realizada no período de agosto de 2012 a novembro de 2013. A amostra foi composta por 20 pacientes portadores de IC (Classes II e III). Foram excluídos os pacientes que apresentaram alterações ósteomioarticulares, e os que participaram de programas de reabilitação. As avaliações consistiram em analisar as pressões inspiratórias e expiratórias máximas, o pico de fluxo expiratório e a espirometria. Na amostra pesquisada 60% (n=12) eram do sexo masculino, com média de idade de 55,3 ± 2,77 anos, 80% (n=16) eram casados, 55% (n=11) tinham como causa da IC a miocardiopatia dilatada e 40% (n=8) apresentaram fração de ejeção variando entre 36 ˫ 40%. Em relação às comorbidades apenas 30% (n=6) apresentaram diabetes, 90% (n=18) hipertensão e 40% (n=8) dislipidemia. Em relação à avaliação da musculatura respiratória, e da função pulmonar, observou-se que os valores médios foram menores significativamente quando comparados ao previsto, porém sem significância quando comparados entre as classes funcionais II e III. Houve maior prevalência de IC entre pacientes do sexo masculino, casados, em decorrência de miocardiopatia dilatada hipertensiva, com FEVE de 36 ˫ 40%. Estes pacientes tendem a reduzir à força muscular respiratória, o pico de fluxo e a função pulmonar. As classes funcionais II e III não apresentaram diferenças significativas em relação aos valores previstos em relação às variáveis analisadas. ANALYSIS OF FUNCTIONAL PULMONARY CHARACTERISTICS AND THEIR REPERCUSSIONS IN PATIENTS WITH HEART FAILURE ABSTRACT Heart failure (HF) is a complex systemic clinical syndrome in which cardiac dysfunction causes inadequate blood supply to meet the tissues' metabolic needs. The aim of this study was to analyze the pulmonary functional characteristics and their repercussions in patients with heart failure at a University Hospital in the city of Fortaleza / CE. Field research, sectional, performed from August 2012 to November 2013. The sample consisted of 20 patients with HF (Classes II and III). Patients who presented osteomioarticular alterations and those who participated in rehabilitation programs were excluded. The evaluations consisted of analyzing maximal inspiratory and expiratory pressures, peak expiratory flow, and spirometry. In the studied sample, 60% (n = 12) were males, with a mean age of 55.3 ± 2.77 years, 80% (n = 16) were married, 55% (n = 11) had as causes to CI the dilated cardiomyopathy and 40% (n = 8) had an ejection fraction ranging from 36 to 40%. Regarding comorbidities, only 30% (n = 6) presented diabetes, 90% (n = 18) hypertension and 40% (n = 8) dyslipidemia. Regarding respiratory muscle evaluation and pulmonary function, it was observed that mean values were significantly lower when compared to predicted, but without significance when compared between functional classes II and III. There was a higher prevalence of HF among male patients, married, due to hypertensive dilated cardiomyopathy, with LVEF of 36 ˫ 40%. These patients tend to reduce respiratory muscle strength, peak flow, and lung function. Functional classes II and III did not present significant differences in relation to predicted values and variables analyzed.

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