| 1. |
- Denfeld, Quin E., et al.
(författare)
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Assessing and managing frailty in advanced heart failure: An International Society for Heart and Lung Transplantation consensus statement
- 2024
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Ingår i: The Journal of Heart and Lung Transplantation. - : Elsevier. - 1053-2498 .- 1557-3117. ; 43:1
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Tidskriftsartikel (refereegranskat)abstract
- Frailty is increasingly recognized as a salient condition in patients with heart failure (HF) as previous studies have determined that frailty is highly prevalent and prognostically significant, particularly in those with advanced HF. Definitions of frailty have included a variety of domains, including physical performance, sarcopenia, disability, comorbidity, and cognitive and psychological impairments, many of which are common in advanced HF. Multiple groups have recently recommended incorporating frailty assessments into clinical practice and research studies, indicating the need to standardize the definition and measurement of frailty in advanced HF. Therefore, the purpose of this consensus statement is to provide an integrated perspective on the definition of frailty in advanced HF and to generate a consensus on how to assess and manage frailty. We convened a group of HF clinicians and researchers who have expertise in frailty and related geriatric conditions in HF, and we focused on the patient with advanced HF. Herein, we provide an overview of frailty and how it has been applied in advanced HF (including potential mechanisms), present a definition of frailty, generate suggested assessments of frailty, provide guidance to differentiate frailty and related terms, and describe the assessment and management in advanced HF, including with surgical and nonsurgical interventions. We conclude by outlining critical evidence gaps, areas for future research, and clinical implementation. J Heart Lung Transplant 2024;43:1-27 (c) 2023 International Society for Heart and Lung Transplantation. All rights reserved.
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| 2. |
- Ekman, Inger, 1952, et al.
(författare)
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Unmet expectations of medications and care providers among patients with heart failure assessed to be poorly adherent: results from the Chronic Heart Failure Intervention to Improve MEdication Adherence (CHIME) study.
- 2017
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Ingår i: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. - : Oxford University Press (OUP). - 1873-1953. ; 16:7, s. 646-654
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Tidskriftsartikel (refereegranskat)abstract
- Ineffective medication management contributes to repeated hospitalisation and death among patients with heart failure. The meaning ascribed to medications and the influence of meaning on how patients manage medications is unknown. The purpose of this study was to explore the meaning and expectations associated with medication use in high-risk, non-adherent patients with heart failure.Patients ( n=265) with heart failure were screened for adherence to prescribed medication using the Morisky medication adherence scale (MMAS). Patients (MMAS score <6; n=44) participated in semistructured interviews, analysed using qualitative content analysis. Of 17 initial themes (223 representative segments), the overarching theme 'unmet expectations' consisted of two subthemes 'working to be heard' by professionals and 'resignation' to both the illness and medications. Patients' expectations were challenged by unexpected work to communicate with providers in general (72 representative segments), and specifically regarding medications (118 representative segments) and feelings of resignation regarding the medication regimen (33 representative segments).These findings suggest that unmet expectations contribute to poor medication management. Improved listening and communication by providers, to establish a common understanding and plan for managing medications may strengthen patient beliefs, resolve feelings of resignation and improve patients' ability to manage medications effectively.
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| 3. |
- Wolf, Axel, et al.
(författare)
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When evidence based medicine cannot keep up with everyday life: The meaning and expectations of medication treatment in patients with poor treatment adherence
- 2017
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Ingår i: European Society of Cardiology (ESC) CONGRESS 2017.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Ineffective medication management contributes to repeated hospitalization and death among patients with chronic heart failure (CHF). The meaning ascribed to medications and the influence of expectations on how patients manage medications is unknown. The purpose of this study was to explore the meaning and expectations associated with medication use in high-risk, non-adherent patients with CHF. Methods and Results: Patients (n=265) with CHF were screened for adherence to prescribed medication using the Morisky Medication Adherence Scale (MMAS). Patients (MMAS score <6; n=44) participated in semi-structured interviews, analyzed using qualitative content analysis. The overarching theme "unmet expectations" comprised two subthemes: "working to be heard" by professionals and "resignation" to both illness and medications. Patients’ expectations were challenged by the amount of unanticipated work required to communicate with providers in general, specifically regarding medications , as well as feelings of resignation regarding the medication regimen. Conclusions: These findings suggest that unmet expectations, of both providers and medications, contribute to poor medication management. Improved listening and communication by providers to establish a common understanding and plan for managing medications may strengthen patient beliefs, resolve feelings of resignation, and improve patients’ ability to effectively manage medications. On Behalf : CHIME Study Funding Acknowledgements : The National Institute for Nursing Research funded this study (NINR_R03 NR011500).
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