Strategies to improve self-management in heart failure patients

Toback, Mehnosh; Clark, Nancy

doi:10.1080/10376178.2017.1290537

Cited by 70 publications

(46 citation statements)

References 93 publications

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“… 2 Effective two-way communication between people with HF and health-care professionals (HCPs) is key to improving patients’ knowledge and understanding of their heart condition and associated with improvements in both adherence to HF-management plans 3 , 4 and patient outcomes. 5 , 6 Communication between patients and HCPs is also needed to aid decisions on pharmacological treatment. It is important that patients are involved in these decisions so that they understand how to take their medication (dose, time of day) and the benefits of treatment, and are able to recognize possible side effects of pharmacotherapy.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of heart failure symptoms, disease severity, treatment decision-making and side effects by patients and cardiologists: a multinational survey in a cardiology setting

Wirta

Balas²,

Proenca

et al. 2018

TCRM

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PurposeExplore the extent to which heart failure (HF) symptoms and side effects of HF treatment experienced by patients are recognized by cardiologists, and concordance between patient–cardiologist perceptions of HF severity and patients’ contributions to treatment decision-making.MethodsA multinational, cross-sectional survey of cardiologists and patients with HF was conducted. Patient-record forms (PRFs) were completed by cardiologists for consecutive consulting patients with HF, who completed a patient self-completion questionnaire (PSC). Responses from PRFs with an associated PSC were analyzed to compare patient- and cardiologist-reported occurrences of HF symptoms and treatment side effects, patient-perceived severity of HF and cardiologists’ perceived risk of death within 12 months, and patient input into treatment decisions. Concordance was calculated as the number of response agreements between PSCs and PRFs for total number of matched pairs. Over- or underreporting of symptoms and side effects by cardiologists relative to patient-reported occurrences were calculated.ResultsOverall, 2,454 patient–cardiologist pairs were identified. High levels of concordance between matched pairs were observed for the occurrence of reported HF symptoms (93%), side effects (77%–98%) and degree of patient input into treatment decisions (74%); for perceived HF severity, concordance was 54%. Most symptoms (except dyspnea when active and fatigue/weakness, experienced by >50% of patients) were underreported by cardiologists. Of patients reporting to have been informed by their cardiologist that their HF was mild, 28% were perceived by their cardiologist to have a moderate–high/very high risk of death within 12 months. Treatment choice was not discussed with almost a third of patients. When discussed, 94% of patients (n=1,540) reported the cardiologist made the final decision. Cardiologists more often under- than overreported the occurrence of side effects reported by patients.ConclusionImproved patient–cardiologist dialogue and shared decision-making is required for optimizing patient care and outcomes in HF.

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Section: Introductionmentioning

confidence: 99%

Perceptions of heart failure symptoms, disease severity, treatment decision-making and side effects by patients and cardiologists: a multinational survey in a cardiology setting

Wirta

Balas²,

Proenca

et al. 2018

TCRM

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“…Silavanich et al [48] found a positive relationship between medication adherence and QoL among 180 HF patients. Adherence to diet (low sodium and low fat), to medication and to fluid restrictions positively affects QoL, and prevents hospitalizations and death, whereas non-adherence is associated with symptom deterioration [49,50]. Having as the ultimate goal to improve QoL, it is crucial to enhance adherence in several ways such as psychosocial support, education, counseling, and scheduled telephone contacts, to evaluate self-efficacy behaviors [51].…”

Section: Discussionmentioning

confidence: 99%

Hospitalized patients with heart failure: the impact of anxiety, fatigue, and therapy adherence on quality of life

Polikandrioti

Κoutelekos

Panoutsopoulos

et al. 2019

Arch Med Sci Atheroscler Dis

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Introduction: Heart failure (HF) is a major global health problem associated with increased morbidity and mortality and reduced quality of life (QoL). The aim of the study was to assess the impact of anxiety, fatigue and adherence to therapeutic guidelines on HF patients' QoL. Material and methods: A hundred and twenty hospitalized HF patients were enrolled in the study. Data collection was performed by completion of the Minnesota Living With Heart Failure Questionnaire (MLHFQ), the Greek version of the Modified Fatigue Impact Scale (MFIS-Greek), the Zung Self-Rating Anxiety Scale (SAS) and a questionnaire that measured adherence to therapeutic guidelines. Results: Data analysis showed moderate levels of anxiety and high levels of adherence to therapeutic guidelines as well as moderate to large effects of HF on patients' fatigue and QoL. A statistically significant positive linear association was observed between anxiety and QoL (rho > 0.6) as well as fatigue and QoL (rho > 0.3). An increase in the anxiety or fatigue score indicated an increase also in the QoL score, meaning that the more anxiety and fatigue a patient felt the worse the QoL also was. Moreover, a statistically significant negative linear association was observed between adherence to therapeutic guidelines and QoL (rho <-0.2). An increase in adherence score indicated a decrease in QoL score, meaning that the more adherent a patient was the better was the QoL. Conclusions: The present findings suggest that QoL may be improved when adherence to therapy is increased and fatigue and anxiety are alleviated.

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“…Despite this information, heart failure patients seem to have poor basic knowledge about their condition, and adherence to self-care behaviors is low (Jaarsma et al, 2013; Spaling et al, 2015; Stut et al, 2015). Suboptimal self-care behaviors are correlated with mortality and quality of life (Seto et al, 2011; Stut et al, 2015; Toback & Clark, 2017). However, improved self-care behaviors can reduce the risk for hospital (re)admissions (Chamberlain, 2017; Lee, Moser, Lennie, & Riegel, 2011; Toback & Clark, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Suboptimal self-care behaviors are correlated with mortality and quality of life (Seto et al, 2011; Stut et al, 2015; Toback & Clark, 2017). However, improved self-care behaviors can reduce the risk for hospital (re)admissions (Chamberlain, 2017; Lee, Moser, Lennie, & Riegel, 2011; Toback & Clark, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Another part of the problem is that low levels of knowledge and poor self-care can be related to cognitive impairment, signifying memory losses, or concentration difficulties (Olano-Lizarraga et al, 2016). Approximately 25% to 75% of the patients have decreased cognitive function (Alagiakrishnan, Mah, Ahmed, & Ezekowitz, 2016; Toback & Clark, 2017). Cognitive deficits in heart failure patients are related to age, gender, relationship status, and educational level (Uchmanowicz, Jankowska-Polanska, Mazur, & Sivarajan Froelicher, 2017), which indicates that certain groups can have special needs for education and information.…”

Section: Introductionmentioning

confidence: 99%

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Heart Failure Patients’ Perceptions of Received and Wanted Information: A Cross-Sectional Study

Andersson

Nordgren

2018

Clin Nurs Res

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This study aimed to investigate heart failure patients' perceptions of received and wanted information and to identify differences regarding received and wanted information in relation to sociodemographic variables. A cross-sectional descriptive design was used. Patients with heart failure ( n = 192) were recruited from six primary health care centers in Sweden. Data were collected by a postal questionnaire. A majority of the respondents had received information about the condition and the medication. Within primary health care, most respondents had been informed about medication. The respondents wanted more information about continued care and treatment, medication, and the condition. There were significant differences between sociodemographic groups concerning what information they wanted. Clinical nurses can support patients with heart failure by using evidence-based methods that strengthen the patients' self-efficacy and by individualized information that increases patients' knowledge and improves their self-care behaviors. Future studies are needed to identify informational needs of particular fragile groups of patients.

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Strategies to improve self-management in heart failure patients

Abstract: Improved self-management will increase compliance, promote patient quality-of-life, advance clinical outcomes, reduce hospital re-admission and will decrease hospitalization costs.

Cited by 70 publications

References 93 publications

Perceptions of heart failure symptoms, disease severity, treatment decision-making and side effects by patients and cardiologists: a multinational survey in a cardiology setting

Perceptions of heart failure symptoms, disease severity, treatment decision-making and side effects by patients and cardiologists: a multinational survey in a cardiology setting

Hospitalized patients with heart failure: the impact of anxiety, fatigue, and therapy adherence on quality of life

Heart Failure Patients’ Perceptions of Received and Wanted Information: A Cross-Sectional Study

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