Patient-centered Outcomes in HFrEF Following a Worsening Heart Failure Event: A Survey Analysis

Dunbar, Sandra B.; Tan, Xi; Lautsch, Dominik; Yang, Mei; Ricker, Bryan; Maculaitis, Martine C.; Nagle, Thomas; Clark, Luther T.; Hilkert, Robert; Brady, Joanne E.; Spertus, John A.

doi:10.1016/j.cardfail.2021.05.017

Cited by 12 publications

(16 citation statements)

References 22 publications

(26 reference statements)

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“…18 Likewise in the US, patients with deteriorating heart failure were more likely to be non-adherent and attain high treatment burden scores using a questionnaire that included the domains of side effects, disruption of daily living activities, convenience, and global satisfaction. 31 The lack of older patients' awareness about the nature of their chronic illness due to Patient-clinician Communication problems (1P, 2D) was also reported in heart failure in a European survey of nurses. They perceived that conversations on illness trajectory was more appropriate if left for relevant moments, such as during exacerbations or towards the end of life, and acknowledged that patient education on this was not commonplace in routine care.…”

Section: Results In Context With Other Literaturementioning

confidence: 96%

Alignment of Doctors’ Understanding of Treatment Burden Priorities and Chronic Heart Failure Patients’ Experiences: A Nominal Group Technique Consultation

Cardona

Sav

Michaleff

et al. 2023

PPA

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To identify and rank areas of treatment burden in chronic heart failure (CHF), including solutions, that should be discussed during the clinical encounter from a patient, and doctors' perspective. Patients and Methods: Patients with CHF and clinicians managing heart failure were invited. Nominal group technique sessions held either face to face or online in 2021-2022, with individual identification of priorities and voting on ranking. Results: Four patient groups (N=22) and one doctor group (N=5) were held. For patients with heart failure, in descending order of priority Doctor-patient communication, Inefficiencies of the healthcare system, Healthcare access issues, Cost implications of treatment, Psychosocial impacts on patients and their families, and Impact of treatment work were the most important treatment burdens. Priorities independently identified by the doctors aligned with the patients' but ranking differed. Patient solutions ranged from involvement of nurses or pharmacists to enhance understanding of discharge planning, through to linkage between health information systems, and maintaining strong family or social support networks. Doctors' solutions covered timing medicines with activities of daily living, patient education on the importance of compliance, medication reviews to overcome clinical inertia, and routine clinical audits. Conclusion:The top treatment burden priorities for CHF patients were related to interaction with clinicians and health system inefficiencies, whereas doctors were generally aware of patients' treatment burden but tended to focus on the complexity of the direct treatment work. Addressing the priority issues identified here can commence with clinicians becoming aware of the issues that matter to patients and proactively discussing feasible immediate and longer-term solutions during clinical encounters.

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Section: Results In Context With Other Literaturementioning

confidence: 96%

Alignment of Doctors’ Understanding of Treatment Burden Priorities and Chronic Heart Failure Patients’ Experiences: A Nominal Group Technique Consultation

Cardona

Sav

Michaleff

et al. 2023

PPA

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“…HF patients with a higher number of comorbidities experience a fluctuating and unpredictable illness trajectory, which leads to more subsequent all-cause hospitalisations and emergency visits, as well as higher HF-related and all-cause care costs 2. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings,3 gradually leading to emotional instability, loss of confidence in the future, lower levels of hope and consequently a decreased quality of life (QoL) 4…”

Section: Introductionmentioning

confidence: 99%

Advanced heart failure patients and family caregivers health and function: randomised controlled pilot trial of online dignity therapy

Yang

Zhang

et al. 2023

BMJ Support Palliat Care

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ObjectivesThis research investigated the effectiveness of the caregiver-mediated online dignity therapy in enhancing dyadic health and family function.MethodsHeart failure (HF) family dyads were recruited between May and December 2021 from a university-affiliated hospital in China. The dyads (N=70) were randomly allocated to the intervention group and the control group. We assessed patients’ outcomes (hope, well-being, Family APGAR Index and quality of life (QoL)) and their family caregivers’ outcomes (anxiety, depression and Family APGAR Index) at baseline (T0), 1 week (T1), 4 weeks (T2) and 8 weeks (T3) after discharge.ResultsFor patients, the difference over time was significant in QoL (p<0.001). The interaction effects were significant for hope (p<0.001), well-being (p<0.001), Family APGAR Index (p<0.001) and QoL (p=0.007). For family caregivers, a significant difference in depression (p=0.001) was found within groups. Meanwhile, the interaction effects were significant on anxiety (p=0.002) and depression (p=0.016).ConclusionsCaregiver-mediated online dignity therapy among patients with advanced HF had potential to enhance patient outcomes (level of hope, well-being, family function and QoL) and alleviate caregiver outcomes (anxiety, depression) at 4-week and 8-week follow-up. Thus, we provided scientific evidence for palliative care for advanced HF.Trial registration numberChiCTR2100053758.

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“…WHF is relative common in HF with reduced ejection fraction (HFrEF): One in six of these patients develops WHF within 18 months following initial diagnosis 1 . Compared with new‐onset HF (NOHF) and CHF, WHF carries a higher risk of rehospitalisation and mortality and is associated with a lower quality of life 6–9 . Therefore, WHF is increasingly being recognized as an inflection point in the clinical course of HF and a separate disease stage with important prognostic value.…”

Section: Introductionmentioning

confidence: 99%

Regional management of worsening heart failure: rationale and design of the CHAIN‐HF registry

et al. 2023

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Aims Heart failure (HF) is a progressive disease in which periods of clinical stability are interrupted by episodes of clinical deterioration known as worsening heart failure (WHF). Patients who develop WHF are at high risk of subsequent death, rehospitalization, and excessive healthcare costs. As such, WHF could be seen as a separate disease stage and precursor of advanced HF. Whether WHF has a substantial health, societal, and economic impact evidence regarding its multifactorial nature and the specific barriers in treatment, including advanced HF therapies, remains scarce. The CHAIN‐HF registry aims to describe the incidence, characteristics, current treatment, and outcomes of WHF. Additionally, it will promote structured regional collaboration and educate on increasing awareness for WHF and describe the implementation of guideline directed medical therapy and utilization of advanced HF therapies in a collaborative network. Methods and results The CHAIN‐HF registry is a prospective, observational, and multicentre study from the collaborating hospitals (Rijnmond HF Network) in the Rotterdam area. Unselected and consecutive patients (irrespective of ejection fraction) with a WHF event will be included. Comprehensive data including demographics, co‐morbidities, treatment, and in‐hospital and post‐discharge outcomes will be collected. Notably, data on socio‐economic status, treatment decisions, and referral for advanced HF therapies will be included. Conclusions CHAIN‐HF will be the first prospective, dedicated WHF registry in a collaborative network of hospitals that will provide robust real‐world evidence on the incidence, characteristics, and outcomes of WHF. Moreover, it will provide information on of the value of regional collaboration to improve awareness and outcomes of WHF.

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Patient-centered Outcomes in HFrEF Following a Worsening Heart Failure Event: A Survey Analysis

Cited by 12 publications

References 22 publications

Alignment of Doctors’ Understanding of Treatment Burden Priorities and Chronic Heart Failure Patients’ Experiences: A Nominal Group Technique Consultation

Alignment of Doctors’ Understanding of Treatment Burden Priorities and Chronic Heart Failure Patients’ Experiences: A Nominal Group Technique Consultation

Advanced heart failure patients and family caregivers health and function: randomised controlled pilot trial of online dignity therapy

Regional management of worsening heart failure: rationale and design of the CHAIN‐HF registry

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