Recall of lifestyle advice in patients recently hospitalised with heart failure: A EuroHeart Failure Survey analysis

Abstract

Background: There are limited data on recall and implementation of lifestyle advice in patients with heart failure (HF). Aim: To investigate what advice patients with HF recall being given, and whether they report following the advice they remember. Methods and results: 3261 patients with suspected HF participating in the EuroHeart Failure Survey were interviewed by a health professional 12 weeks after hospital discharge. Patients recalled receiving 46% of pre-specified items of advice and 67% reported that they followed these completely. Both recall (53%) and implementation (71%) was best in patients with left ventricular systolic dysfunction (LVSD). In multivariate analysis, younger age, male sex, patient awareness of the condition and patients reporting that they received a clear explanation of the diagnosis by a health professional, all factors associated with having LVSD, were the strongest predictors of recall. Conclusions: Recall of and adherence to advice by patients with HF in this large European cross-sectional survey was disappointing. Responsibility for patient education lies with health professionals who should ensure that patients receive and understand advice, and are able to recall and follow it. A greater awareness of the issues surrounding lifestyle advice and more evidence supporting its value could improve patient care.

The burden of chronic obstructive pulmonary disease in patients hospitalized with heart failure

“…Despite an average hospital stay of 13 days, it is not always possible to complete titration of betablockers during hospitalization. This calls for hospitalized patients to be sufficiently educated; ample opportunity exists but implementation remains below optimal [24]. Specialized outpatient settings are another way of assuring good clinical practice.…”

“…Clinicians should not remain satisfied with prescription only; titration has to be completed as suggested in guidelines. As this is frequently not possible, even in a cardiology setting [32], specialized ambulatory settings should be developed [24,33]. Whether this is feasible in an ever-aging and fragile population with CHF is an unresolved issue, but the recently completed Cardiac Insufficiency Bisoprolol Study in the Elderly (CIBIS-ELD) trial [34] should provide the missing link for our clinical practice.…”

State of the Science

“…Limited evidence to date suggests that self-reported anxiety may be present in up to 50% to 70% of HF patients. 7,14,144 Older adults with HF report anxiety levels 60% higher than those without cardiac disease, and 40% of all persons with HF have major anxiety. 145,146 HF is associated with anxiety levels as high as or worse than those seen in cardiac patients without HF or in patients with cancer or lung disease.…”

Hjertepasienter tar ikke medisiner riktig

“…Etterlevelse av medikamenter og råd som blir gitt av helsepersonell er også et problem blant yngre personer, og da spesielt blant menn (20,21).…”