关于心力衰竭疾病自我管理支持计划有效性和特征的叙事综合
Apinya Koontalay1, Mari Botti1, Anastasia Hutchinson1,2
1School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia.
ESC heart failure
|February 5, 2024
概括
有效的心力衰竭 (HF) 疾病自我管理支持 (DSMS) 计划显著降低了再入院和死亡率. 中等到高强度的干预措施显示最有前途,但在低收入国家适用性有限.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心力衰竭 (HF) 疾病自我管理支持 (DSMS) 计划对于改善患者结果至关重要.
- 提高这些计划在各种环境中的有效性和适用性至关重要.
- 了解成功的高频DSMS的关键要素对于临床实践和政策至关重要.
研究的目的:
- 研究心力衰竭的DSMS程序的特点和有效性.
- 确定这些计划对生存和急性护理再入院的影响.
- 评估现有证据对低收入和中等收入国家 (LMICs) 的通用性和适用性.
主要方法:
- 采用了一个叙事元合成方法.
- 包括以高频率DSMS为重点的随机对照试验 (RCT) 的系统审查.
- 在没有语言限制的情况下,主要数据库 (Cochrane,MEDLINE,Embase) 进行了搜索.
主要成果:
- 在HF再接收 (RR 0.64-0.85),所有原因的再接收 (RR 0.85-0.95) 和所有原因的死亡率 (RR 0.67-0.87) 中观察到显著减少.
- 44.2%的RCT表明急性护理再入院减少和改善生存率.
- 中等到高强度的干预措施是最有效的,特别是那些允许早期识别和响应HF不稳定的干预措施.
结论:
- 高频DSMS程序,特别是中度到高强度的程序,有效地减少再接收并提高生存率.
- 大多数证据来自高收入国家,限制了对LMICs的概括性.
- 为LMICs量身定制HF DSMS需要仔细考虑干预强度,后续工作以及在资源有限的环境中可行性.
相关概念视频
01:17Pathophysiology of Heart Failure
1.6K
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...
1.6K
01:30Stress Prevention and Stress Management Techniques VI
32
Adopting a healthier lifestyle often requires overcoming significant challenges, but leveraging psychological, social, and cultural resources can facilitate meaningful change. Effective self-change hinges on understanding and applying key tools such as motivation and goal setting, which help sustain efforts toward long-term health benefits.
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...
32
01:26Heart Failure Drugs: Inotropic Agents
588
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...
588
01:22Heart Failure Drugs: β-Blockers
340
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
340
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
431
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...
431
01:28Self-Help Support Groups
30
Self-help support groups are voluntary, community-based organizations that provide a platform for individuals with shared concerns to exchange support, insights, and practical strategies for coping with life challenges. Typically led by group members or paraprofessionals, these groups form a cornerstone of mental health care, especially in reaching populations that are underserved by traditional healthcare systems.
Accessibility and Cost-Effectiveness
One of the primary strengths of self-help...
Accessibility and Cost-Effectiveness
One of the primary strengths of self-help...
30