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Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
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Heart Failure Drugs: Inotropic Agents01:26

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
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Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
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An Innovative Patient-Centred Approach to Heart Failure Management: The Best Care Heart Failure Integrated

Christopher Licskai1,2,3, Anna Hussey2, Madonna Ferrone2,4

  • 1Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

CJC Open
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Summary

Integrated disease management (IDM) for heart failure (HF) significantly reduced hospitalizations and emergency visits. This community-based program also improved quality of life and adherence to guideline-directed medical therapy (GDMT).

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Area of Science:

  • Cardiology
  • Public Health
  • Health Services Research

Background:

  • Heart failure (HF) management is complex due to intricate therapeutic recommendations.
  • Integrated disease management (IDM) promotes guideline-directed care but requires community-setting impact evaluation.

Purpose of the Study:

  • To evaluate the impact of a community-based integrated disease management (IDM) program on heart failure (HF) patients.
  • To assess changes in HF-related health service utilization, quality of life, and adherence to guideline-directed medical therapy (GDMT).

Main Methods:

  • Retrospective evaluation of 715 patients in a community-based IDM program (2016-2023).
  • Pre- and post-intervention analysis of HF-related health-service use, quality of life, and concordance with GDMT.
  • Analysis included patients from specialist-care and primary-care clinics.

Main Results:

  • Significant reductions in annualized HF-related acute health-service use: hospitalizations (36.3 to 8.5 per 100 patient-years) and emergency department visits (31.8 to 13.1 per 100 patient-years).
  • Improved concordance with GDMT, with increased uptake of triple and quadruple therapies.
  • Over 50% of patients reported clinically relevant improvements in quality of life.

Conclusions:

  • Community-based IDM programs for HF show potential in reducing acute health service utilization.
  • These programs may enhance patient quality of life and improve adherence to GDMT.
  • Further validation through randomized controlled trials is recommended for these preliminary findings.