What kind of patient education and self-care support do patients with heart failure receive, and by whom? Implementation of the ESC guidelines for heart failure in three European regions

Baldewijns, Karolien; Boyne, Josiane; Rohde, Carla; Maesschalck, Lieven De; Devillé, Aleidis; Brandenburg, Vincent; Bleser, Leentje De; Derickx, Mieke; Bektas, S.; Rocca, Hans‐Peter Brunner‐La

doi:10.1016/j.hrtlng.2022.07.013

Cited by 7 publications

(9 citation statements)

References 23 publications

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“…Clinical trials have shown that LVEF is an independent risk factor for predicting HF prognosis when the heart cavity is enlarged. 23 , 24 Leclercq et al conducted a comparative study between HF education intervention and standard outpatient‐based intervention in HF patients with reduced nonvalvular ejection fraction, and both intervention approaches significantly improved the treatment outcomes. 25 However, patients in the HF education intervention exhibited better compliance and significantly improved self‐management abilities compared to the standard intervention group.…”

Section: Discussionmentioning

confidence: 99%

“…Myocardial cell transformation and enlargement of the heart cavity are key factors in HF progression. Clinical trials have shown that LVEF is an independent risk factor for predicting HF prognosis when the heart cavity is enlarged 23,24. Leclercq et al conducted a comparative study between HF education intervention and standard outpatient-based intervention in HF patients with reduced nonvalvular ejection fraction, and both intervention approaches significantly improved the treatment outcomes 25.…”

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confidence: 99%

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Improving therapeutic outcomes in heart failure with reduced nonvalvular ejection fraction: A clinical study of heart failure education intervention

Tian,

Li,

Zhang

et al. 2024

Clinical Cardiology

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ObjectiveThe current study delves into the impact of heart failure education intervention on improving therapeutic outcomes for heart failure (HF) patients with reduced nonvalvular ejection fraction.MethodsThere involved a total of 60 HF patients with non‐valvular ejection fraction reduction who met the inclusion requirements. Patients enrolled were randomly distributed into an observation group and a control group. The observation group received heart failure education intervention, while the control group received conventional intervention. The therapeutic effect, changes in physical indicators, cardiac function indicators, coagulation function, self‐management scale scores, and the incidence of adverse cardiovascular events were meticulously evaluated.ResultsThe total effective proportion in the observation group was 96.67%, which was significantly higher than the control group's proportion of 76.67% (p < .05). After treatment, several parameters in the observation group showed significant improvements compared to the control group: hs‐CRP, IL‐6, LVEDV value, LVESV value, PT value, APTT value, and TT value were all evidently lower in the observation group. Additionally, the cardiac index, LVEF value, and heart failure self‐management scale fraction were significantly higher in the observation group compared to the control group (p < .05). Furthermore, the incidence of adverse cardiovascular events in the observation group was only 6.67%, which was significantly lower than the control group's incidence of 20.00% (p < .05).ConclusionHeart failure education intervention demonstrates effectiveness in improving the therapeutic outcomes for HF patients and reduced nonvalvular ejection fraction. Additionally, it enhances patients' self‐management abilities. Given these positive results, it is highly recommended to promote and implement HF education intervention in clinical practice.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Improving therapeutic outcomes in heart failure with reduced nonvalvular ejection fraction: A clinical study of heart failure education intervention

Tian,

Li,

Zhang

et al. 2024

Clinical Cardiology

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“…A recent study found that patients have low self‐confidence, in particular, related to regular exercising, eating a low‐salt diet, and flu vaccination 15 . Various approaches to teaching self‐care behaviours have been described, but, of concern, physicians appear to engage poorly with this aspect of patient management 16–22 . Newer approaches may be valuable, as suggested by the Swedish Self‐care Management Intervention in Heart Failure (SMART‐HF) multicentre randomized trial.…”

Section: Discussionmentioning

confidence: 99%

“… 15 Various approaches to teaching self‐care behaviours have been described, but, of concern, physicians appear to engage poorly with this aspect of patient management. 16 , 17 , 18 , 19 , 20 , 21 , 22 Newer approaches may be valuable, as suggested by the Swedish Self‐care Management Intervention in Heart Failure (SMART‐HF) multicentre randomized trial. Although small ( n = 118), this demonstrated that a mobile device‐based educational intervention improved the EHFScB‐9 score compared with usual care and resulted in fewer days spent in hospital.…”

Section: Discussionmentioning

confidence: 99%

Knowledge about self‐efficacy and outcomes in patients with heart failure and reduced ejection fraction

Yang

Kondo

Adamson

et al. 2023

European J of Heart Fail

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AimAlthough education in self‐management is thought to be an important aspect of the care of patients with heart failure, little is known about whether self‐rated knowledge of self‐management is associated with outcomes. The aim of this study was to assess the relationship between patient‐reported knowledge of self‐management and clinical outcomes in patients with heart failure and reduced ejection fraction (HFrEF).Methods and resultsUsing individual patient data from three recent clinical trials enrolling participants with HFrEF, we examined patient characteristics and clinical outcomes according to responses to the ‘self‐efficacy’ questions of the Kansas City Cardiomyopathy Questionnaire. One question quantifies patients' understanding of how to prevent heart failure exacerbations (‘prevention’ question) and the other how to manage complications when they arise (‘response’ question). Self‐reported answers from patients were pragmatically divided into: poor (do not understand at all, do not understand very well, somewhat understand), fair (mostly understand), and good (completely understand). Cox‐proportional hazard models were used to evaluate time‐to‐first occurrence of each endpoint, and negative binomial regression analysis was performed to compare the composite of total (first and repeat) heart failure hospitalizations and cardiovascular death across the above‐defined groups. Of patients (n = 17 629) completing the ‘prevention’ question, 4197 (23.8%), 6897 (39.1%), and 6535 (37.1%) patients had poor, fair, and good self‐rated knowledge, respectively. Of those completing the ‘response’ question (n = 17 637), 4033 (22.9%), 5463 (31.0%), and 8141 (46.2%) patients had poor, fair, and good self‐rated knowledge, respectively. For both questions, patients with ‘poor’ knowledge were older, more often female, and had a worse heart failure profile but similar treatment. The rates (95% confidence interval) per 100 person‐years for the primary composite outcome for ‘poor’, ‘moderate’ and ‘good’ self‐rated knowledge in answer to the ‘prevention’ question were 12.83 (12.11–13.60), 12.08 (11.53–12.65) and 11.55 (11.00–12.12), respectively, and for the ‘response’ question were 12.88 (12.13–13.67), 12.22 (11.60–12.86) and 11.56 (11.07–12.07), respectively. The lower event rates in patients with ‘good’ self‐rate knowledge were accounted for by lower rates of cardiovascular (and all‐cause) death and not hospitalization for worsening heart failure.ConclusionsPoor patient‐reported ‘self‐efficacy’ may be associated with higher rates of mortality. Evaluation of knowledge of ‘self‐efficacy’ may provide prognostic information and a guide to which patients may benefit from further education about self‐management.

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“…Providing adequate and up-to-date education regarding lifestyle based on scientific evidence, when available, or expert opinions is inextricably linked to an individual approach to chronic diseases [ 143 ]. Patient education is a key component of the multidisciplinary approach, which should be performed at the time of HF diagnosis, at discharge, and ideally before it [ 8 ].…”

Section: Evidence-based Medicine: Appropriateness Of Treatment and Pa...mentioning

confidence: 99%

Heart Failure with Preserved Ejection Fraction: How to Deal with This Chameleon

Lucà,

Oliva,

Abrignani

et al. 2024

JCM

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Heart failure with preserved ejection fraction (HFpEF) is characterized by a notable heterogeneity in both phenotypic and pathophysiological features, with a growing incidence due to the increase in median age and comorbidities such as obesity, arterial hypertension, and cardiometabolic disease. In recent decades, the development of new pharmacological and non-pharmacological options has significantly impacted outcomes, improving clinical status and reducing mortality. Moreover, a more personalized and accurate therapeutic management has been demonstrated to enhance the quality of life, diminish hospitalizations, and improve overall survival. Therefore, assessing the peculiarities of patients with HFpEF is crucial in order to obtain a better understanding of this disorder. Importantly, comorbidities have been shown to influence symptoms and prognosis, and, consequently, they should be carefully addressed. In this sense, it is mandatory to join forces with a multidisciplinary team in order to achieve high-quality care. However, HFpEF remains largely under-recognized and under-treated in clinical practice, and the diagnostic and therapeutic management of these patients remains challenging. The aim of this paper is to articulate a pragmatic approach for patients with HFpEF focusing on the etiology, diagnosis, and treatment of HFpEF.

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What kind of patient education and self-care support do patients with heart failure receive, and by whom? Implementation of the ESC guidelines for heart failure in three European regions

Cited by 7 publications

References 23 publications

Improving therapeutic outcomes in heart failure with reduced nonvalvular ejection fraction: A clinical study of heart failure education intervention

Improving therapeutic outcomes in heart failure with reduced nonvalvular ejection fraction: A clinical study of heart failure education intervention

Knowledge about self‐efficacy and outcomes in patients with heart failure and reduced ejection fraction

Heart Failure with Preserved Ejection Fraction: How to Deal with This Chameleon

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