News | January 28, 2015

Acute Heart Failure Patients Bounce Back to ERs for Complex Reasons

Lack of knowledge, physical disability among top challenges with self-care

acute heart failure, patient readmission, ER, self-care, challenges

January 28, 2015 — A tool designed to assess what interferes with acute heart failure patients' ability to care for themselves after hospital discharge holds promise for improving patient outcomes and reducing readmissions to the hospital. The patient survey, designed by researchers at Vanderbilt University, was published online in Annals of Emergency Medicine, along with patient responses that shed light on the non-medical issues that limit patients' ability to care for themselves.

"In order to reduce the number of patients returning to the emergency department for heart failure exacerbations, we need a better handle on what they can and cannot do for themselves after hospital discharge and why," said lead study author Richard Holden, Ph.D., of Indiana University in Indianapolis. "More than three-quarters of acute heart failure patients in the ER are experiencing exacerbation of their condition, not something new. Many of those exacerbations are the result of self-care challenges, including inadequate access to medications or lack of knowledge, which theoretically can be modified for the better."

Holden and his team surveyed 31 acute heart failure patients who visited the emergency department.

Of 47 different self-care barriers (such as transportation problems, insurance problems and caregiver responsibilities), an average of 15 per patient were indicated as sometimes or often present. Thirty-three of the barriers were reported by at least 25 percent of all patients. The top 10 most prevalent barriers were:

  • Co-morbidities
  • Physical disability
  • Degree of sickness
  • Feeling frustrated
  • Knowledge about disease
  • Functional limitations
  • Memory and attention deficits
  • Special occasions (minor disruptions)
  • Lack of control
  • Disruptions (major disruptions)

 

Weather, physical obstacles and a food culture incompatible with dietary restrictions were also frequently mentioned as barriers to self-care. Certain barriers also compound each other. In one example, a patient was sick but also taking care of others and working full time, leaving little time for her own self-care.

"The first step in addressing these barriers is to develop a focused, valid and feasible measurement instrument for self-care barriers in the ER," said Holden. "The social determinants of health, along with factors such as poverty and a lack of transportation, must be addressed in order to improve the ER bounce-back rate for acute heart failure patients."

For more information: www.acep.org

Related Content

News | Heart Failure | July 09, 2020
July 9, 2020 – The Minneapolis Heart Institute Foundation (MHIF) is conducting additional research on a novel hydroge
Navin Kapur, M.D., Tufts Medical Center, shows preCardia device and its anatomical positioning in the patient to treat heart failure..

Navin Kapur, M.D., Tufts Medical Center, shows preCardia device and its anatomical positioning in the patient.

News | Heart Failure | June 23, 2020
June 23, 2020 — The U.S.
Patients with worsening heart failure and reduced ejection fraction who received the investigational drug vericiguat had a significantly lower rate of cardiovascular death or heart failure hospitalization compared with those receiving a placebo, based on research presented at the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC) #ACC20/#WCCardio
News | Heart Failure | March 29, 2020
March 29, 2020 — Patients with worsening heart failure and reduced ejection fraction who received the investigational
Dapagliflozin Reduces Heart Failure Worsening and Death in DAPA-HF Sub-analysis. #ACC20 #ACC2020
News | Heart Failure | March 28, 2020
March 28, 2020 — New data from a sub-analysis of the landmark Phase III...
News | Heart Failure | March 05, 2020
March 5, 2020 — Abbott recently received Breakthrough Device designation from the U.S.
Some of the new devices technologies to treat heart failure that are either in clinical trials or were recently cleared by the U.S. FDA. #heartfailure

Some of the new devices technologies to treat heart failure that are either in clinical trials or were recently cleared by the U.S. FDA. 

Feature | Heart Failure | February 21, 2020 | Dave Fornell, Editor
There are several new tools being added to the clinical armamentarium in the fight against...
Tufts Medical Center created a heart failure team approach to care for its patients. The program includes an interventional heart failure fellowship program, where interventional cardiologists learn more advanced care, as show here with an ECMO procedure being performed in a cath lab at Tufts. The interventional cardiologists learn how to better care for heart failure patients and interface with surgeons, intensivists and others on the HF care team. The operator is Nevin Kapur. Photo by Dave Fornell.

Tufts Medical Center created a heart failure team approach to care for its patients. The program includes an interventional heart failure fellowship program, where interventional cardiologists learn more advanced hemodynamic support methods, as shown here with an ECMO procedure being performed in a cath lab at Tufts. The interventional cardiologists learn how to better care for heart failure patients and interface with surgeons, intensivists and others on the HF care team. Photo by Dave Fornell.

Feature | Heart Failure | February 20, 2020 | Dave Fornell, Editor
There is no, single magic bullet in heart failure (HF) to easily reduce readmission rates or easily reverse this...
he U.S. Food and Drug Administration (FDA) has approved Carmat's investigational device exemption (IDE) application to start a U.S. early feasibility study (EFS) of its total artificial heart.
News | Heart Failure | February 12, 2020
February 12, 2020 — The U.S.