Ng TP, Niti M. Trends and ethnic differences in hospital admissions and mortality for congestive heart failure in the elderly in Singapore, to Factors precipitating congestive heart failure — Role of patient non-compliance. J Assoc Physicians India ; Comparative study of systolic and diastolic cardiac failure in elderly hospitalized patients in a tertiary care hospital in Southwest India. J Clin Diagn Res ; Kumar RK, Tandon R.
Rheumatic fever and rheumatic heart disease: The last 50 years. Indian J Med Res ; Global and regional burden of disease and risk factors, Systematic analysis of population health data. Lancet ; The community control of rheumatic fever and rheumatic heart disease: Report of a WHO international cooperative project. Bull World Health Organ ; Status of rheumatic heart disease in rural Pakistan. Clinical profile of rheumatic fever and rheumatic heart disease: A study of 2, cases. Indian Heart J ; Meenakshisundaram R, Thirumalaikolundusubramanian P.
Valvular heart disease in Indian subcontinent: Social issues. The present consensus, however, is to recommend that the patients be instructed not to add salt to already prepared food and to avoid industrialized and canned food which are rich in sodium. Self-care adherence, including diet restriction, was again significantly correlated to knowledge. Fluid restriction in severe HF - Fluid restriction in HF seems to be less frequent in clinical practice due to a still limited level of scientific evidence.
In daily practice, the maximum amount of 1. The lack of adhesion to prescription of control of ingested fluids may also be explained by the greater interference in the autonomy and life quality of the patient represented by this measure differently from salt restriction and drug prescription, which are better established as part of the treatment.
Fluid restriction frequently originates thirst, which is one of the less well tolerated symptoms for moderate to severe HF Many believe that the rate of fluid intake should be left free according to the patient needs, with the avoidance however of excess or insufficient consumption. A european study reported the design of a randomized, cross-over and prospective study in which the control group is instructed to comply with a maximum fluid intake of 1.
The authors believe that fluid intake based on physiological needs corrects the feelings of dry mouth and thirst, saving the patient from another source of stress in the non-pharmacological treatment Alcohol and tobacco use - According to the recommendations of American and Brazilian associations, the excessive use of alcoholic drinks and tobacco should be avoided in view of their negative effects on the cardiovascular system Non-adherence to the tobacco and alcohol restriction was significantly associated to the number of hospital admissions due to HF in a study published in Alcohol reduces myocardial contractility and may cause arrythmias Vaccination - Annual immunization against influenza must be recommended to all HF patients, according to national and international guidelines Immunization reduces the risk of respiratory infections, preventing thus episodes of disease decompensation.
Self-care education, including the control of non-pharmacological measures, should be part of the daily management of HF patients at both hospital and ambulatory settings. HF patients in the hospital environment represent the best situation to start the educational process and training of the patient and their caregivers, using the impact represented by the admission to the hospital and by the symptoms of decompensation to establish the adherence to the treatment. The days following recovery are particularly useful to the adaptation of the patients and their families to the understanding and assessment of these measures for maintenance of the clinical stability.
The early planning of the hospital leave, which includes daily visits to evaluate and reinforce adherence, give the patients and their family support, and emphasise the recognition of signs and symptoms of worsening, is an approach which can be successfully employed to reach those objectives.
Finally, nurses at HF clinics together with the other professionals integrating the multidisciplinary team have a fundamental role in the follow-up and management of patients. This approach aims at the permanent training, reinforcement, improvement and evaluation of self-care abilities, which include weight monitoring, sodium and fluid restriction, physical activities, regular use of medications, monitoring of signs and symptoms of worsening and the early seeking of medical help. Randomized trial of an education and support intervention to prevent readmission of patients with heart failure.
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J Am Coll Cardiol ; Precipitating factors leading to decompesation of heart failure. Arch Intern Med ; Non-compliance in patients with heart failure: how can we manage it? Eur J Heart Fail ;7 1 What do discharge patients know about their medication? Patient Educ Couns ;56 3 Factors influencing knowlewdge of and adherance to self-care among patients with heart failure. Arch Intern Med ; 14 Telemanagement of heart failure: a diuretic treatment algorithm for advanced practice nurses. Heart Lung ; Echer IC. Rev Latino-am Enfermagem setembro-outubro ;13 5 Randomized trial of a daily electronic home monitoring system in patients with advanced heart failure:the weight monitoring in heart failure WHARF trial.
Am Heart J ; Outpatient management of heart failure-program development and experience in clinical practice.
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Report No. Self-care abilities of patients with heart failure. Bushnell FK. Self-care teaching for congestive heart failure patients. J Gerontol Nurs ; Compliance and effectiveness of 1 year's home telemonitoring-the report of a pilot study of patients with chronic heart failure.
Eur J Heart Fail ; Sociedade Brasileira de Cardiologia. Arq Bras Cardiol ;79 4 American Heart Association. Structured telephone support reduced all-cause mortality RR 0. Neither structured telephone support nor telemonitoring demonstrated effectiveness in reducing the risk of all-cause hospitalisations structured telephone support: RR 0.
Seven structured telephone support studies reported length of stay, with one reporting a significant reduction in length of stay in hospital. Nine telemonitoring studies reported length of stay outcome , with one study reporting a significant reduction in the length of stay with the intervention.
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One telemonitoring study reported a large difference in the total number of hospitalisations for more than three days, but this was not an analysis of length of stay per hospitalisation. Nine of 11 structured telephone support studies and five of 11 telemonitoring studies reported significant improvements in health-related quality of life. Nine structured telephone support studies and six telemonitoring studies reported costs of the intervention or cost effectiveness. Three structured telephone support studies and one telemonitoring study reported a decrease in costs and two telemonitoring studies reported increases in cost, due both to the cost of the intervention and to increased medical management.
Adherence was rated between Seven of nine studies that measured these outcomes reported significant improvements in heart failure knowledge and self-care behaviours. Structured telephone support and non-invasive telemonitoring in the management of people with heart failure Review question We reviewed the evidence about the effect of structured telephone support and non-invasive telemonitoring in the management of people with heart failure. Background In the context of limited health funding and a rapidly expanding population of older people, it is increasingly difficult for healthcare systems to provide high-quality care to those with heart failure.
Study characteristics We include 41 full-text peer-reviewed studies of either structured telephone support or home telemonitoring in this review. Key results This review demonstrates that supporting people with heart failure at home using information technology can reduce the rates of death and heart failure-related hospitalisation.
Quality of the evidence We assessed the quality of the evidence for the primary outcomes in this review all-cause mortality , all-cause hospitalisation and heart failure-related hospitalisation according to GRADE criteria. Authors' conclusions:. Search strategy:.