Section 6: Nonpharmacologic Management and Health Care Maintenance in Patients With Chronic Heart Failure

America, Heart Failure Society of

doi:10.1016/j.cardfail.2005.11.011

Cited by 19 publications

(4 citation statements)

References 86 publications

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“…Although the assessment of 24-hour urine sodium excretion is considered the gold standard method, the measurement of spot uNa could provide an approximate estimate of sodium excretion, with increased convenience and low cost [ 25 , 29 , 31 - 34 ]. On the other hand, a previous study demonstrated that spot uNa was reduced by decongestive therapy for advanced HF, which might provide insightful information to titrate the diuretic dose [ 35 , 36 ]. Hence, in general, decreased uNa in HF patients can be a result of low salt intake or effective diuretic therapy [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of a Telehealth Program With Voice Recognition Technology in Patients With Chronic Heart Failure: Feasibility Study

Lee

Park

Choi

et al. 2017

JMIR Mhealth Uhealth

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BackgroundDespite the advances in the diagnosis and treatment of heart failure (HF), the current hospital-oriented framework for HF management does not appear to be sufficient to maintain the stability of HF patients in the long term. The importance of self-care management is increasingly being emphasized as a promising long-term treatment strategy for patients with chronic HF.ObjectiveThe objective of this study was to evaluate whether a new information communication technology (ICT)–based telehealth program with voice recognition technology could improve clinical or laboratory outcomes in HF patients.MethodsIn this prospective single-arm pilot study, we recruited 31 consecutive patients with chronic HF who were referred to our institute. An ICT-based telehealth program with voice recognition technology was developed and used by patients with HF for 12 weeks. Patients were educated on the use of this program via mobile phone, landline, or the Internet for the purpose of improving communication and data collection. Using these systems, we collected comprehensive data elements related to the risk of HF self-care management such as weight, diet, exercise, medication adherence, overall symptom change, and home blood pressure. The study endpoints were the changes observed in urine sodium concentration (uNa), Minnesota Living with Heart Failure (MLHFQ) scores, 6-min walk test, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as surrogate markers for appropriate HF management.ResultsAmong the 31 enrolled patients, 27 (87%) patients completed the study, and 10 (10/27, 37%) showed good adherence to ICT-based telehealth program with voice recognition technology, which was defined as the use of the program for 100 times or more during the study period. Nearly three-fourths of the patients had been hospitalized at least once because of HF before the enrollment (20/27, 74%); 14 patients had 1, 2 patients had 2, and 4 patients had 3 or more previous HF hospitalizations. In the total study population, there was no significant interval change in laboratory and functional outcome variables after 12 weeks of ICT-based telehealth program. In patients with good adherence to ICT-based telehealth program, there was a significant improvement in the mean uNa (103.1 to 78.1; P=.01) but not in those without (85.4 to 96.9; P=.49). Similarly, a marginal improvement in MLHFQ scores was only observed in patients with good adherence (27.5 to 21.4; P=.08) but not in their counterparts (19.0 to 19.7; P=.73). The mean 6-min walk distance and NT-proBNP were not significantly increased in patients regardless of their adherence.ConclusionsShort-term application of ICT-based telehealth program with voice recognition technology showed the potential to improve uNa values and MLHFQ scores in HF patients, suggesting that better control of sodium intake and greater quality of life can be achieved by this program.

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Section: Discussionmentioning

confidence: 99%

Impact of a Telehealth Program With Voice Recognition Technology in Patients With Chronic Heart Failure: Feasibility Study

Lee

Park

Choi

et al. 2017

JMIR Mhealth Uhealth

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“…All authors, including three ED physicians (two attending, one resident) and two non-clinician researchers (one human factors engineer, one social scientist), reviewed the literature and suggested for the instrument barriers identified in clinical guidelines 38-42 or across multiple systematic reviews and individual articles. 10,15,29,31,43-55 A few less commonly reported barriers were added because they were identified in the research team's concurrent study of chronic heart failure patients.…”

Section: Methodsmentioning

confidence: 99%

Self-care Barriers Reported by Emergency Department Patients With Acute Heart Failure: A Sociotechnical Systems-Based Approach

Holden

Schubert

Eiland

et al. 2015

Annals of Emergency Medicine

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Objective To pilot a sociotechnical systems-based instrument that assesses the prevalence and nature of self-care barriers among patients presenting to the emergency department (ED) with acute heart failure. Methods A semi-structured instrument for measuring self-reported self-care barriers was developed and administered by ED clinicians and non-clinician researchers to 31 ED patients diagnosed with acute heart failure. Responses were analyzed using descriptive statistics and qualitative content analysis. Feasibility was assessed by examining participant cooperation rates, instrument completion times, item nonresponse, and data yield. Results Of 47 distinct self-care barriers assessed, a median of 15 per patient were indicated as “sometimes” or “often” present. Thirty-four specific barriers were reported by over 25% of patients and nine were reported by over 50%. The sources of barriers included the person, self-care tasks, tools and technologies, and organizational, social, and physical contexts. Seven of the top ten most prevalent barriers were related to patient characteristics and the next three to the organizational context (e.g., life disruptions). A preliminary feasibility assessment found few item nonresponses or comprehension difficulties, good cooperation, high data yield from both closed- and open-ended items, but opportunities to reduce median administration time and variability. Conclusions An instrument assessing self-care barriers from multiple system sources can be feasibly implemented in the ED. Further research is required to modify the instrument for widespread use and evaluate its implementation across institutions and cultural contexts. Self-care barriers measurement can be one component of broader inquiry into the distributed health-related “work” activity of patients, caregivers, and clinicians.

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“…Zick et al, 2008 77 Significant improvement in maximal workload using bicycle ergometry 69,70 Increase in exercise tolerance 68,70 Reduction of the pressure×heart rate product (systolic blood pressure in mm Hg times heart rate per min and divided by 100) 70,71,73,78 Improvement in HF symptoms (eg, dyspnea, fatigue, palpitations) Theoretical potentiation of coronary and peripheral vasodilators 79 Conflicting evidence on interaction with digoxin 79,80 Appears to be safe when used in combination with angiotensinconverting enzyme inhibitors, β-blockers 67,79 Generally well tolerated with mild-to-moderate side effects 64 Cardiac (eg, palpitations, chest pain) 71,72 Gastrointestinal concerns 69,71,72 Neurological (eg, dizziness, migraine, headache) 69,71 Influenza-like symptoms 67,69 Potential increased risk of orthostatic hypotension 79 Potential increased risk of arrhythmia 79 Insufficient informa- Keith et al, 2019 94 Schoenenberger et al, 2012 95 Smithline et al, 2007 96 Shimon et al, 1995 97 Improvement in LVEF after 7 d of IV thiamine compared with baseline but not compared with placebo with long-term furosemide therapy 97 Significant improvement in LVEF in symptomatic chronic HFrEF 43 No major harm…”

Section: Coenzyme Q10/ubiquinone/ubiquinolmentioning

confidence: 99%

“…Zick et al, 2008 77 Significant improvement in maximal workload using bicycle ergometry 69,70 Increase in exercise tolerance Theoretical potentiation of coronary and peripheral vasodilators 79 Conflicting evidence on interaction with digoxin 79,80 Appears to be safe when used in combination with angiotensinconverting enzyme inhibitors, β-blockers 67,79 Generally well tolerated with mild-to-moderate side effects 64 Cardiac (eg, palpitations, chest pain) 71,72 Gastrointestinal complaints 69,71,72 Neurological (eg, dizziness, migraine, headache) 69,71 Influenza-like symptoms 67,69 Potential increased risk of orthostatic hypotension 79 Potential increased risk of arrhythmia 79 Insufficient The HOPE and HOPE-TOO Trial Investigators 183 Marchioli et al, 2006 184 Chae et al, 2012 185 In the Women's Health Study, 185 women aged >45 y randomly assigned to vitamin E 600 IU every other day was not associated with increased risk for systolic HF. A prespecific subgroup analysis showed a 40% reduction in the risk of HF with preserved ejection fraction.…”

Section: Yogamentioning

confidence: 99%

Complementary and Alternative Medicines in the Management of Heart Failure: A Scientific Statement From the American Heart Association

Chow¹,

Bozkurt²,

Baker³

et al. 2023

Circulation

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Complementary and alternative medicines (CAM) are commonly used across the world by diverse populations and ethnicities but remain largely unregulated. Although many CAM agents are purported to be efficacious and safe by the public, clinical evidence supporting the use of CAM in heart failure remains limited and controversial. Furthermore, health care professionals rarely inquire or document use of CAM as part of the medical record, and patients infrequently disclose their use without further prompting. The goal of this scientific statement is to summarize published efficacy and safety data for CAM and adjunctive interventional wellness approaches in heart failure. Furthermore, other important considerations such as adverse effects and drug interactions that could influence the safety of patients with heart failure are reviewed and discussed.

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Section 6: Nonpharmacologic Management and Health Care Maintenance in Patients With Chronic Heart Failure

Cited by 19 publications

References 86 publications

Impact of a Telehealth Program With Voice Recognition Technology in Patients With Chronic Heart Failure: Feasibility Study

Impact of a Telehealth Program With Voice Recognition Technology in Patients With Chronic Heart Failure: Feasibility Study

Self-care Barriers Reported by Emergency Department Patients With Acute Heart Failure: A Sociotechnical Systems-Based Approach

Complementary and Alternative Medicines in the Management of Heart Failure: A Scientific Statement From the American Heart Association

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