Disease Management via Self-care Promotion Program among Heart Failure Patients in Outpatient Cardiology Clinic

Abstract

Heart failure (HF) is a chronic and destructive disease that interrupts a person’s lifestyle and threatens the quality of life (King-Daily et al., 2022). More than six million people in the United States have HF, and approximately 800,000 new cases are diagnosed yearly (King-Daily et al., 2022). In addition, HF prevalence is increasing, with estimates indicating that more than eight million Americans may have HF by 2030. An increasingly large portion of healthcare resources goes towards treating cardiovascular diseases, especially an HF, and many of these costs are attributed to hospitalization. When they used HF disease management programs, clinicians reported a reduction in the risk of hospital readmission when combined with a structured follow-up that focused on the optimization of guideline-directed medication therapy (GDMT) for HF, thorough education of self-care, medication adherence, patient-centered care, and supports from healthcare providers (Riley, 2015). In addition, HF programs can help stabilize the lives of HF patients and improve their overall quality of life (Jiang & Wang, 2021). At the cardiac project site (a cardiac clinic), HF patients are not receiving adequate HF education for self-care management, resulting in an insufficient understanding of HF, non-compliance with the GDMT for HF, increased symptoms of exacerbations, and hospitalization or rehospitalization. Therefore, the plan was to develop and implement an effective HF program using evidenced-based practice for HF patients in an outpatient cardiology clinic The vision of this project was to improve the quality of life of patients with heart failure. The mission was to create and implement a patient-centered heart failure disease management program in an outpatient cardiology clinic. The objective of the project was to create and implement a HF program that would improve patients’ health outcomes. During the initial clinic visit, each HF patient completed a pre-education questionnaire for baseline data. Detailed HF education and printable HF educational materials were then provided to the patient. Following the initial visit, the project leader conducted three consecutive weekly phone call follow-up interviews. Lastly, a three months post-initial visit follow-up call was made to each participant. The questionnaire used for follow-up calls was the same one used during the initial visit. Ultimately the project leader used the data to determine if the actions met their short-term and long-term goals. Data were collected from 56 HF patients participating in the project. The short-term goals for self-care management and early recognition of HF symptoms of exacerbation were not met. However, it was evident that there was an improvement from the initial visit when compared to each patient’s final three months post-initial visit follow-up. The short-term goals for reducing heart failure rehospitalizations and medication adherence were met. In addition, 100% of patients who participated in this project were satisfied with the program.