Delays in Seeking Medical Care in Hospitalized Patients with Decompensated Heart Failure

Goldberg, Robert J.; Goldberg, Jordan; Pruell, Sean; Yarzebski, Jorge L.; Lessard, Darleen M.; Spencer, Frederick A.; Gore, Joel M.

doi:10.1016/j.amjmed.2007.10.032

Cited by 45 publications

(61 citation statements)

References 22 publications

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“…Furthermore, it is often difficult for chronic HF patients to differentiate between baseline symptoms and signs of deterioration. 26 Gender was independently associated with patient delay, which has also been reported in another study 9 ; male patients were more likely to delay in seeking care. This result was found for all patients, as well for patients with a history of HF.…”

Section: Discussionsupporting

confidence: 53%

“…Although delay in HF patients has been studied previously [6][7][8][9][10] , these studies actually assessed pre-hospital delay ( Figure 1). However, little is known on patient delay as we defined earlier as the 4 time from worsening symptoms to actually contacting a health care provider, which reflects the patients' own action in seeking care.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 In HF patients, many admissions could have been prevented if patients had sought medical care in an earlier stage of worsening symptoms. 2,[6][7][8][9] However, long prehospital delay times are common in HF patients. 6,7,10 In studying delay in cardiovascular patients, it is important to distinguish between 'patient delay' (time from worsening symptoms to actually contacting a health care provider) and 'transportation delay' (time from contacting a health care provider to arrival at the hospital).…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated With Patient Delay in Seeking Care After Worsening Symptoms in Heart Failure Patients

Nieuwenhuis¹,

Jaarsma²,

Veldhuisen³

et al. 2011

Journal of Cardiac Failure

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Factors Associated With Patient Delay in Seeking Care After Worsening Symptoms in Heart Failure Patients

Nieuwenhuis¹,

Jaarsma²,

Veldhuisen³

et al. 2011

Journal of Cardiac Failure

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“…In prior studies, edema was identified as one of the most common symptoms that contribute to a delay in seeking care, 4,13) and it predicted a two-fold risk of increased delay. 14,15) On the basis of these fi ndings, we decided to examine if the patients sought care when their feet/legs became more swollen.…”

Section: Methodsmentioning

confidence: 99%

Insufficient Self-Care Is an Independent Risk Factor for Adverse Clinical Outcomes in Japanese Patients With Heart Failure

et al. 2013

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SummarySelf-care is a cornerstone for the successful management of heart failure (HF). The purpose of this study was to examine the impacts of HF self-care on prognosis in Japanese patients with HF. A total of 283 HF outpatients (age 64 ± 14, 70% male, 52% HFrEF) were enrolled. We asked patients to answer about their adhevence to 5 self-care behaviors (medication, eating a low-sodium diet, regular exercise, daily weight check, and treatment seeking behavior). On the basis of the results, we classifi ed patients into a good self-care group and a poor self-care group. The primary outcome was HF hospitalization and/or cardiac death. In total, 65% of patients were classifi ed into the poor self-care group. During a median follow-up of 2 years, cardiac events occurred more frequently in the poor self-care group (22% versus 9.6%, P = 0.013). Poor self-care was an independent risk factor for cardiac events in Cox regression analysis adjusted for clinical parameters (hazard ratio = 2.86, P = 0.005). Poor self-care was also associated with an increased number of HF hospitalizations as well as an extended length of hospital stay for HF. Poor knowledge about HF was an independent determinant for poor self-care in multivariate logistic regression analysis (odds ratio = 0.92, P = 0.019). Insuffi cient self-care is an independent risk factor for cardiac events in Japanese patients with HF. (Int Heart J 2013; 54: 382-389) Key words: Compliance, Mortality, Morbidity, Patient education M ortality from coronary heart disease has been consistently declining over the past several decades. In concert with this decline and aging of the population, the number of patients who are at risk for heart failure (HF) is increasing to the point where now there are > 1.2 million ambulatory care patients in Japan.1) The course of HF is marked by frequent exacerbations that result in hospitalization, which are costly and contribute to poor quality of life for patients with HF.2) There are multiple modifi able factors known to precipitate hospitalization for HF exacerbation, which includes non-adherence to medications, diet, and failure to seek timely medical care for escalating symptoms.3) For this reason, approximately half of admissions are considered to be potentially preventable with adequate self-care. 3,4) Effective self-care is an essential and adjunctive strategy to evidence-based medical treatment in delaying the progression of HF. Data from a meta-analysis have demonstrated that HF disease management programs aimed at promoting selfcare reduced rehospitalization rates and mortality. 5) HF patients require self-care behaviors to maintain their physiological stability (self-care maintenance) and to respond to symptoms when they occur (self-care management).6) HF self-care maintenance behavior includes taking medications, eating a low-sodium diet, routine exercise, and symptom monitoring. 6)With respect to the relationship between such HF selfcare behaviors and subsequent clinical outcomes, several studies have shown that poor adherence...

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“…As shown in the multi-centre study by Goldberg et al (2008), medical chart information collected on care-seeking delay behavior data was missing for 56% of the sample. {{4127 Goldberg, Robert J.…”

Section: Interventions and Other Health System Encountersmentioning

confidence: 99%

Non–Symptom-Related Factors Contributing to Delay in Seeking Medical Care by Patients With Heart Failure: A Narrative Review

Gravely

Tamim

Smith

et al. 2011

Journal of Cardiac Failure

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Background-Delay in seeking timely medical care by patients with acute coronary syndrome and stroke has been well established in the literature, but less is known about delay in care-seeking behavior by patients with heart failure (HF). The purpose of this narrative review was to synthesize the literature regarding non symptom-related factors that contribute to delay in seeking medical care for HF symptoms.

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Delays in Seeking Medical Care in Hospitalized Patients with Decompensated Heart Failure

Cited by 45 publications

References 22 publications

Factors Associated With Patient Delay in Seeking Care After Worsening Symptoms in Heart Failure Patients

Factors Associated With Patient Delay in Seeking Care After Worsening Symptoms in Heart Failure Patients

Insufficient Self-Care Is an Independent Risk Factor for Adverse Clinical Outcomes in Japanese Patients With Heart Failure

Non–Symptom-Related Factors Contributing to Delay in Seeking Medical Care by Patients With Heart Failure: A Narrative Review

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