The Efficacy of Self-care Behaviors, Educational Interventions, and Follow-up Strategies on Hospital Readmission and Mortality Rates in Patients with Heart Failure: Self-care Behaviors in Heart Failure Patients
Self-care Behaviors in Heart Failure Patients
DOI:
https://doi.org/10.31661/gmj.v12i.3116Keywords:
Self-care, Heart Failure, Education, Patient Readmission, HospitalizationAbstract
Heart failure (HF), a worldwide epidemic with significant morbidity and mortality risks, is frequently secondary to cardiovascular disorders and probably is the common final way to survive patients. Almost 25% of hospitalized patients with acute HF are expected to be readmitted within 30 days post-discharge, and the rates of rehospitalization increase to almost one-third at 60 days and 60 percent within one year of discharge. Although care planning for patients with heart failure is complex, multidisciplinary, and resource-dependent, optimal self-care management along with appropriate educational intervention and follow-up strategy could be able to reduce readmissions, decline the duration of hospitalization, increase life expectancy, decrease the rates of mortality, and reduce costs of healthcare services for patients with HF. However, there are contradictions in previous reports about the efficacy of self-care, mainly due to patients’ non-adherence to self-care behaviors. Therefore, the current study aimed to review the investigations on the effectiveness of self-care of HF patients in reducing hospital readmissions and increasing quality of life, and discuss novel approaches for predischarge educational interventions and postdischarge follow-up strategies.
References
Gaidai O, Cao Y, Loginov S. Global cardiovascular diseases death rate prediction. Curr Probl Cardiol. 2023:101622.
https://doi.org/10.1016/j.cpcardiol.2023.101622
Dini FL, Pugliese NR, Ameri P, Attanasio U, Badagliacca R, Correale M et al. Right ventricular failure in left heart disease: from pathophysiology to clinical manifestations and prognosis. Heart Fail Rev. 2022:1-10.
https://doi.org/10.1007/s10741-022-10282-2
McBeath K, Cowie MR. Heart failure. classification and pathophysiology: Med; 2022.
https://doi.org/10.1016/j.mpmed.2022.05.001
Roh J, Hill JA, Singh A, Valero-Muñoz M, Sam F. Heart failure with preserved ejection fraction: heterogeneous syndrome, diverse preclinical models. Circ Res. 2022;130(12):1906-25.
https://doi.org/10.1161/CIRCRESAHA.122.320257
Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GM, Coats AJ. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2022;118(17):3272-87.
https://doi.org/10.1093/cvr/cvac013
Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: the Rotterdam Study. Eur Heart J. 2004;25(18):1614-9.
https://doi.org/10.1016/j.ehj.2004.06.038
Sahle BW, Owen AJ, Mutowo MP, Krum H, Reid CM. Prevalence of heart failure in Australia: a systematic review. BMC Cardiovasc Disord. 2016;16:1-6.
https://doi.org/10.1186/s12872-016-0208-4
Bollano E, Redfors B, Rawshani A, Venetsanos D, Völz S, Angerås O et al. Temporal trends in characteristics and outcome of heart failure patients with and without significant coronary artery disease. ESC Heart Fail. 2022;9(3):1812-22.
https://doi.org/10.1002/ehf2.13875
Chaudhry A, Selwyn J, Adams E, Bradley EA. Heart Failure in Complex Congenital Heart Disease of the Adult. Curr Cardiol Rep. 2022;24(11):1727-35.
https://doi.org/10.1007/s11886-022-01788-0
Heidenreich PA, Fonarow GC, Opsha Y, Sandhu AT, Sweitzer NK, Warraich HJ et al. Economic issues in heart failure in the United States. J Card Fail. 2022;28(3):453-66.
https://doi.org/10.1016/j.cardfail.2021.12.017
Hoang-Kim A, Parpia C, Freitas C, Austin PC, Ross HJ, Wijeysundera HC et al. Readmission rates following heart failure: a scoping review of sex and gender based considerations. BMC Cardiovascular Disorders. 2020;20:1-19. BMC Cardiovasc Disord
https://doi.org/10.1186/s12872-020-01422-3
Poon S, Leis B, Lambert L, MacFarlane K, Anderson K, Blais C et al. The State of Heart Failure Care in Canada: Minimal Improvement in Readmissions Over Time Despite an Increased Number of Evidence-Based Therapies. CJC open. 2022;4(8):667-75.
https://doi.org/10.1016/j.cjco.2022.04.011
Dunlay SM, Redfield MM, Weston SA, Therneau TM, Hall Long K, Shah ND et al. Hospitalizations after heart failure diagnosis: a community perspective. J Am Coll Cardiol. 2009;54(18):1695-702.
https://doi.org/10.1016/j.jacc.2009.08.019
Muzzarelli S, Leibundgut G, Maeder MT, Rickli H, Handschin R, Gutmann M et al. Predictors of early readmission or death in elderly patients with heart failure. Am Heart J. 2010;160(2):308-14.
https://doi.org/10.1016/j.ahj.2010.05.007
Mangini S, Pires PV, Braga FGM, Bacal F. Decompensated heart failure. Einstein (Sao Paulo). 2013;11:383-91.
https://doi.org/10.1590/S1679-45082013000300022
Toukhsati S, Jaarsma T, Babu A, Driscoll A, Hare DL. Self-care interventions that reduce hospital readmissions in patients with heart failure; towards the identification of change agents. Clin Med Insights Cardiol. 2019;13:1179546819856855.
https://doi.org/10.1177/1179546819856855
Bodie KL. Keep ticking. congestive heart failure self management program: 6338; 2022.
Iyngkaran P, Hanna F, Andrew S, Horowitz JD, Battersby M, De Courten MP. Comparison of short and long forms of the Flinders program of chronic disease SELF-management for participants starting SGLT-2 inhibitors for congestive heart failure (SELFMAN-HF): protocol for a prospective, observational study. Front Med. 2023;10:1059735.
https://doi.org/10.3389/fmed.2023.1059735
Lainscak M, Blue L, Clark AL, Dahlström U, Dickstein K, Ekman I et al. Self-care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2011;13(2):115-26.
https://doi.org/10.1093/eurjhf/hfq219
Riegel B, Jaarsma T, Lee CS, Strömberg A. Integrating symptoms into the middle-range theory of self-care of chronic illness. ANS Adv Nurs Sci. 2019;42(3):206.
https://doi.org/10.1097/ANS.0000000000000237
Riegel B, Lee CS, Dickson VV. Self care in patients with chronic heart failure. Nat Rev Cardiol. 2011;8(11):644-54.
https://doi.org/10.1038/nrcardio.2011.95
Jaarsma T, Hill L, Bayes-Genis A, La Rocca HPB, Castiello T, Čelutkienė J et al. Self-care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2021;23(1):157-74.
https://doi.org/10.1002/ejhf.2008
Riegel B, Dickson VV. A situation-specific theory of heart failure self-care. Situation Specific Theories: Development, Utilization, and Evaluation in Nursing. 2021:149-60.
https://doi.org/10.1007/978-3-030-63223-6_11
Riegel B, Moser D, Buck H, Dickson V, Dunbar S, Lee C et al. American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association J Am Heart Assoc. 2017;6(9):e006997.
https://doi.org/10.1161/JAHA.117.006997
Aamodt IT, Lycholip E, Celutkiene J, von Lueder T, Atar D, Falk RS et al. Self-care monitoring of heart failure symptoms and lung impedance at home following hospital discharge: longitudinal study. J Med Internet Res. 2020;22(1):e15445.
Jonkman NH, Schuurmans MJ, Jaarsma T, Shortridge-Baggett LM, Hoes AW, Trappenburg JC. Self-management interventions: proposal and validation of a new operational definition. J Clin Epidemiol. 2016; 80:34-42.
https://doi.org/10.1016/j.jclinepi.2016.08.001
Boyde M, Peters R, New N, Hwang R, Ha T, Korczyk D. Self-care educational intervention to reduce hospitalisations in heart failure: a randomised controlled trial. European Society of Cardiology. 2018;17(2):178-85.
https://doi.org/10.1177/1474515117727740
Collins SP, Liu D, Jenkins CA, Storrow AB, Levy PD, Pang PS et al. Effect of a self-care intervention on 90-day outcomes in patients with acute heart failure discharged from the emergency department: a randomized clinical trial. JAMA cardiology. 2021;6(2):200-8.
https://doi.org/10.1001/jamacardio.2020.5763
Madanat L, Saleh M, Maraskine M, Halalau A, Bukovec F. Congestive heart failure 30-day readmission: descriptive study of demographics, co-morbidities, heart failure knowledge, and self-care. Cureus. 2021;13(10):e18661.
https://doi.org/10.7759/cureus.18661
Jonkman NH, Westland H, Groenwold RH, Ågren S, Atienza F, Blue L et al. Do self-management interventions work in patients with heart failure An individual patient data meta-analysis. Circ. 2016;133(12):1189-98.
https://doi.org/10.1161/CIRCULATIONAHA.115.018006
Jovicic A, Holroyd-Leduc JM, Straus SE. Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials. BMC Cardiovasc Disord. 2006;6:1-8.
https://doi.org/10.1186/1471-2261-6-43
Atherton JJ, Sindone A, De Pasquale CG, Driscoll A, MacDonald PS, Hopper I et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: guidelines for the prevention, detection, and management of heart failure in Australia 2018. Heart, Lung and Circulation. 2018;27(10):1123-208.
https://doi.org/10.1016/j.hlc.2018.06.1042
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021;42(36):3599-726.
https://doi.org/10.1093/eurheartj/ehab368
Cajita MI, Cajita TR, Han H-R. Health literacy and heart failure: a systematic review. J Cardiovasc Nurs. 2016;31(2):121.
https://doi.org/10.1097/JCN.0000000000000229
Adarmouch L, Elyacoubi A, Dahmash L, El Ansari N, Sebbani M, Amine M. Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco. J Clin Transl Endocrinol. 2017;7:54-9.
https://doi.org/10.1016/j.jcte.2017.01.002
Dickson VV, Riegel B. Are we teaching what patients need to know Building skills in heart failure self-care. Heart & Lung. 2009;38(3):253-61.
https://doi.org/10.1016/j.hrtlng.2008.12.001
Johnson AE, Routh S, Taylor CN, Leopold M, Beatty K, McNamara DM et al. Developing and implementing an mHealth heart failure self-care program to reduce readmissions: randomized controlled trial. JMIR cardio. 2022;6(1):e33286.
Arslanian-Engoren C, Giordani B, Nelson K, Moser DK. A pilot study to evaluate a computer-based intervention to improve self-care in patients with heart failure. J Cardiovasc Nurs. 2021;36(2):157.
https://doi.org/10.1097/JCN.0000000000000782
Rahmani A, Vahedian-Azimi A, Sirati-Nir M, Norouzadeh R, Rozdar H, Sahebkar A. The effect of the teach-back method on knowledge, performance, readmission, and quality of life in heart failure patients. Cardiol Res Pract. 2020;2020:8897881.
https://doi.org/10.1155/2020/8897881
Wu J, Yu Y, Xu H. Influence of targeted motivational interviewing on self-care level and prognosis during nursing care of chronic heart failure. Am J Transl Res. 2021;13(6):6576.
Jiang Y, Shorey S, Nguyen HD, Wu VX, Lee CY, Yang LF et al. The development and pilot study of a nurse-led HOMe-based HEart failure self-Management Programme (the HOM-HEMP) for patients with chronic heart failure, following Medical Research Council guidelines. Eur J Cardiovasc Nurs. 2020;19(3):212-22.
https://doi.org/10.1177/1474515119872853
Dianati M, Asmaroud SR, Shafaghi S, Naghashzadeh F. Effects of an Empowerment Program on Self-Care Behaviors and Readmission of Patients with Heart Failure: a Randomized Clinical Trial. Tanaffos. 2020;19(4):312.
Cañon-Montañez W, Duque-Cartagena T, Rodríguez-Acelas AL. Effect of educational interventions to reduce readmissions due to heart failure decompensation in adults a systematic review and meta-analysis. Investigación y Educación en Enfermería. 2021;39(2):e05.
https://doi.org/10.17533/udea.iee.v39n2e05
Herber OR, Ehringfeld I, Steinhoff P, Whittal A. Identifying relevant factors for successful implementation into routine practice: expert interviews to inform a heart failure self-care intervention (ACHIEVE study). BMC Health Serv Res. 2021;21:1-11.
https://doi.org/10.1186/s12913-021-06596-w
Hsing-Mei C, Shan-Tair W, Shyh-Jong W, Chee-Siong L, Fetzer SJ, Liang-Miin T. Effects of predischarge patient education combined with postdischarge follow-ups on self-care, readmission, sleep, and depression in patients with heart failure. J Nurs Res. 2020;28(5):e112.
https://doi.org/10.1097/JNR.0000000000000395
Deek H, Noureddine S, Allam D, Newton PJ, Davidson PM. A single educational intervention on heart failure self-care: Extended follow-up from a multisite randomized controlled trial. Eur J Cardiovasc Nurs. 2021;20(3):212-9.
https://doi.org/10.1177/1474515120941645
Taniguchi C, Seto N, Shimizu Y. Outpatient nursing support for self-monitoring in patients with chronic heart failure. PloS one. 2021;16(7):e0254019.
https://doi.org/10.1371/journal.pone.0254019
Griffiths S, Stephen G, Kiran T, Okrainec K. "She knows me best": a qualitative study of patient and caregiver views on the role of the primary care physician follow-up post-hospital discharge in individuals admitted with chronic obstructive pulmonary disease or congestive heart failure. BMC Fam Pract. 2021;22(1):1-9.
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