Heart failure exacerbation leading to hospital admission: a cross-sectional study
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Objectives The aim of this pilot study was to investigate cause(s) of heart failure (HF). Setting The emergency department and medical wards at Malmö University Hospital. Method A cross sectional pilot study. Main outcome measures Comparison of compliance, comprehension and optimal treatment on a population basis between men and women, younger (≤75 years) and elderly (>75 years) patients, and patients in different New York Heart Association (NYHA) classes, in order to assess if exacerbation could have been caused by any of these factors. Results Of the 47 patients included, 60% reported high compliance, with significant differences between women and men, and between patients in NYHA class IV and patients in NYHA class III. Comprehension on self-care was poor. Only 30% weighed themselves regularly and 45% did not limit the amount of fluids. No more than 28% reported they would contact a health professional in the case of experiencing more symptoms. Suboptimal treatment was also found to be a great concern. The majority were treated with recommended agents, but had not achieved target dose as recommended in the guidelines. Conclusion This pilot study indicates suboptimal HF management of patients with HF prior to hospital admission due to HF exacerbation. A larger study is needed to assess the extent of the problem, and establish the need and nature of management improvement in different patient subgroups.
KeywordsAdherence Compliance Heart failure Hospital admission Self-care Sub-optimal treatment Sweden
The authors would like to thank Steve Hudson and Tobias Dreishulte at the University of Strathclyde for their help in designing the project protocol and for providing us with the Scottish MAT and Tommy Eriksson at the University of Uppsala for valuable feedback. We would also like to thank the staff at the Emergency Department and the internal medical wards where this pilot study was conducted.
EL was supported in part through a scholarship from the Swedish Pharmaceutical Association.
Conflicts of Interest
The authors have no conflicts of interest to declare.
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