Burden of treatment in patients with chronic heart failure – A cross-sectional study

Nordfonn, Oda Karin; Morken, Ingvild Margreta; Bru, Lars Edvin; Larsen, Alf Inge; Husebø, Anne Marie Lunde

doi:10.1016/j.hrtlng.2021.02.003

Cited by 20 publications

(24 citation statements)

References 43 publications

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“…The impact index captures how much engagement with self‐care regimens interferes with the domains of role and social activity limitations (ability to work, family responsibility, and daily and social activities) and physical and mental fatigue (negative emotional and physical experience from engaging with self‐care). In CHF patients in Norway, Nordfonn et al 35 . observed moderate correlations between HRQoL scores (MLHFQ total score) and the BoT dimensions (role/social activity limitations and physical/mental fatigue), which are comparable with our findings.…”

Section: Discussionsupporting

confidence: 92%

“…The impact index captures how much engagement with self-care regimens interferes with the domains of role and social activity limitations (ability to work, family responsibility, and daily and social activities) and physical and mental fatigue (negative emotional and physical experience from engaging with self-care). In CHF patients in Norway, Nordfonn et al 35 observed moderate correlations between HRQoL scores (MLHFQ total score) and the BoT dimensions (role/social activity limitations and physical/mental fatigue), which are comparable with our findings. In our work, we examined this further by looking at the MLHFQ sub-score, which showed a strong association between emotional sub-score of MLHFQ and the impact of self-care (PETS impact index), further adding to Nordfonn et al 14 conclusions that psychological distress adds to BoT and impairs HRQoL.…”

Section: Discussionsupporting

confidence: 92%

“…Despite a low median symptom burden score (HFSS), participants reported moderate mean levels of burden in PETS domains of exercise/physical therapy , diet , difficulty with heartcare services , and physical and mental fatigue . In our population, PETS individual domain scores were between those reported in a multi‐morbid population 22 and those reported in a Norwegian CHF population 35 . At least 50% of our participants denied healthcare professionals having advised them about specific diet or exercise recommendations.…”

Section: Discussionmentioning

confidence: 48%

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SYMptoms in chronic heart failure imPACT on burden of treatment (SYMPACT): a cross‐sectional survey

et al. 2022

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AimsThis study aimed to describe patient-reported symptoms and burden of treatment (BoT) experienced by patients with chronic heart failure (CHF). BoT describes the illness workload, individual capacity to perform that work, and resultant impact on the individual. Overwhelming BoT is related to poor quality of life and worse clinical outcomes. This research is the first to explore symptoms and BoT in people with CHF, in the UK. Methods and resultsThis is a cross-sectional questionnaire survey of CHF patients. Participants completed the Heart Failure Symptom Survey (HFSS; max score 10) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ; max scores: physical 40, emotional 25, and total 105), which measured symptoms. BoT was measured with the Patient Experience with Treatment and Self-management (PETS; max score 100) questionnaires. Participant characteristics and questionnaire results were summarized using descriptive statistics. Relationships between symptoms and BoT, summarized by the workload and impact indices, were explored using Spearman's and Pearson's correlation coefficients together with scatter plots. The survey was completed by 333 participants, mean age of 71 (±13) years old. The majority (89%) were recruited from secondary care NHS trusts, and 25% were female. All types of heart failure were represented. Mean symptom scores were as follows: HFSS burden score: 2.4 (±2.1), and MLHFQ scores: physical score 20 (±12.4), emotional score 9.9 (±8.1), and total score 41.3 (±26.3). The highest mean PETS domain scores were exercise [51.3 (±24.7)], diet [40.3 (±22.7)], difficulty with healthcare services [39.9 (±21.3)], and physical and mental fatigue [36.0 (±25.7)]. Pairwise correlations were observed between HFSS scores and MLHFQ physical and emotional sub-scores with PETS workload and impact indices. Positive correlations were weak to moderate (0.326-0.487) between workload index and symptoms, and moderate to strong between impact index and symptoms (0.553-0.725). The P value was 0.006, adjusted by Bonferroni's correction. Conclusions Symptoms are associated with BoT in CHF patients. Although symptom burden was low, CHF patients reported higher levels of burden around self-care activities of exercise, diet, healthcare interaction, as well as physical and mental fatigue due to engagement with self-care regimens. Observed higher levels of burden were in key self-care areas for CHF and suggest areas where service delivery and support of CHF patients may be improved to reduce BoT. Clinicians could individualize their consultations by focusing on troublesome symptoms, as well as alleviating illness workload, which may better enable patients to live well with CHF.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 48%

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SYMptoms in chronic heart failure imPACT on burden of treatment (SYMPACT): a cross‐sectional survey

et al. 2022

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“…It poses a burden on the health care system in general and on primary care specifically because the total number of patients with HF is increasing, reflecting the chronic course of the disease as well as population growth and aging [ 2 , 3 ]. Symptomatic HF is a complex clinical syndrome with a symptom burden of dyspnea and fatigue [ 4 ] and can be troublesome for patients and their families because of frequent hospitalizations and symptom and treatment burden negatively affecting their quality of life (QoL) [ 5 - 7 ]. QoL is understood as a multidimensional and subjective concept that includes physical, functional, emotional, and social well-being [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Upon discharge from the hospital, many patients transition from care provided by health professionals in a safe hospital setting to individual self-care at home [ 11 ]. This period, when patients transition between hospital and home, is a vulnerable and stressful time for patients with HF and many struggle to perform recommended self-care and navigate the health care system, particularly when posthospitalization care is poorly executed as a result of inadequate coordination of resources or follow-up [ 5 , 7 ]. Of any diagnosis, HF is associated with the highest 30-day all-cause readmission rate (approximately 20%), whereas nearly 35% of the patients with HF are readmitted within 90 days [ 2 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

Husebø¹,

Storm²,

Urstad³

et al. 2022

J Med Internet Res

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Background Heart failure (HF) is a clinical syndrome with high incidence rates, a substantial symptom and treatment burden, and a significant risk of readmission within 30 days after hospitalization. The COVID-19 pandemic has revealed the significance of using eHealth interventions to follow up on the care needs of patients with HF to support self-care, increase quality of life (QoL), and reduce readmission rates during the transition between hospital and home. Objective The aims of this review are to summarize research on the content and delivery modes of HF posthospitalization eHealth interventions, explore patient adherence to the interventions, and examine the effects on the patient outcomes of self-care, QoL, and readmissions. Methods A restricted systematic review study design was used. Literature searches and reviews followed the (PRISMA-S) Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension checklist, and the CINAHL, MEDLINE, Embase, and Cochrane Library databases were searched for studies published between 2015 and 2020. The review process involved 3 groups of researchers working in pairs. The Mixed Methods Appraisal Tool was used to assess the included studies’ methodological quality. A thematic analysis method was used to analyze data extracted from the studies. Results A total of 18 studies were examined in this review. The studies were published between 2015 and 2019, with 56% (10/18) of them published in the United States. Of the 18 studies, 16 (89%) were randomized controlled trials, and 14 (78%) recruited patients upon hospital discharge to eHealth interventions lasting from 14 days to 12 months. The studies involved structured telephone calls, interactive voice response, and telemonitoring and included elements of patient education, counseling, social and emotional support, and self-monitoring of symptoms and vital signs. Of the 18 studies, 11 (61%) provided information on patient adherence, and the adherence levels were 72%-99%. When used for posthospitalization follow-up of patients with HF, eHealth interventions can positively affect QoL, whereas its impact is less evident for self-care and readmissions. Conclusions This review suggests that patients with HF should receive prompt follow-up after hospitalization and eHealth interventions have the potential to improve these patients’ QoL. Patient adherence in eHealth follow-up trials shows promise for successful future interventions and adherence research. Further studies are warranted to examine the effects of eHealth interventions on self-care and readmissions among patients with HF.

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Comment on “Burden of Treatment in Patients With Chronic Heart Failure—A Cross-Sectional Study”

Jamil

Khan

Ansari

2023

Current Problems in Cardiology

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Burden of treatment in patients with chronic heart failure – A cross-sectional study

Cited by 20 publications

References 43 publications

SYMptoms in chronic heart failure imPACT on burden of treatment (SYMPACT): a cross‐sectional survey

SYMptoms in chronic heart failure imPACT on burden of treatment (SYMPACT): a cross‐sectional survey

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

Comment on “Burden of Treatment in Patients With Chronic Heart Failure—A Cross-Sectional Study”

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