USE OF DRUGS AND PATIENT’S QUALITY OF LIFE IN HEART FAILURE CLINIC

  • Mitja Lainščak Interni oddelek Splošna bolnišnica Murska Sobota Dr. Vrbnjaka 6 9000 Murska Sobota
  • Bojan Korošec Interni oddelek Splošna bolnišnica Murska Sobota Dr. Vrbnjaka 6 9000 Murska Sobota
Keywords: heart failure, heart failure clinic, quality of life, pharmacological treatment

Abstract

Background. Heart failure is associated with poor quality of life and frequent hospitalizations. Implementation of the clinical trials results, especially prescription of adequate daily doses, is regarded as insufficient. In Slovenia there is no data on quality of life in patients treated in heart failure clinic.

Aim. This study assessed the effects of heart failure clinic on patients pharmacological treatment, number of hospitalisations and quality of life.

Methods. Patients with established heart failure were enrolled on a basis of the European Society of Cardiology guidelines.

Results. During seven months 48 patients (28 men and 20 women), aged 68.4 ± 11.9 years were included. Half of the patients referred after heart failure hospitalisation. After mean of 3.8 ± 1.5 visits in mean time of 2.9 ± 2.6 months more patients received angiotenzin converting enzyme inhibitors and beta adrenergic blockers (90 vs. 100%, p < 0.05 and 42% vs. 88%, p < 0.001, respectively). There was also an increase in mean daily dose of both drugs: from 60% to 86% for angiotenzin converting enzyme inhibitors and from 26% to 44% for beta adrenergic blockers (p < 0.001 for both). Hospital admissions were reduced by 79%. Quality of life, health, MLHFQ result and NYHA class all significantly improved (p < 0.001).

Conclusions. Heart failure clinic can significantly improve patient’s quality of life and pharmacological treatment as well as reduce number of admissions due to heart failure.

Downloads

Download data is not yet available.

References

The CONSENSUS Trial study group. Effects of enalapril on mortality in severe heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987; 316: 1429–35.

The SOLVD investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991; 325: 293–302.

The SOLVD investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fraction. N Engl J Med 1992; 327: 685–91.

ATLAS Study Group. Packer M, Poole-Wilson PA, Armstrong PW et al. Comparative effects of low and high doses of the angiotenzin-converting enzyme inhibitor, lisinopril on morbidity and mortality in chronic heart failure. Circulation 1999; 100: 2312–8.

The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin converting enzyme inhibitor, ramipril on cardiovascular events in high risk patients. N Engl J Med 2000; 342: 145–53.

Packer M, Bristow MR, Cohn J et al. Effect of carvedilol on morbidity and mortality in chronic heart failure. N Engl J Med 1996; 334: 1349–55.

Goldstein S, Hjalmarson A. The mortality effect of metoprolol CR/XL in patients with heart failure: results of the MERIT-HF trial. Clin Cardiol 1999; 22: Suppl V: V30–V35.

CIBIS-II Study. The cardiac insufficiency bisoprolol study II (CIBIS-II): a randomised trial. Lancet 1999; 353: 9–13.

Packer M, Coats AJS, Fowler MB, Katus HA et al. Effects of carvedilol in severe chronic heart failure. N Engl J Med 2001; 344: 1651–8.

Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J for the Randomized Aldactone Evaluation Study Investigators. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999; 341: 709–17.

Task force for the diagnosis and treatment of chronic heart failure of the European society of cardiology. Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J 2001; 22: 1527–60.

Philbin EF, Rocco TA. Use of angiotenzin-converting enzyme inhibitors in heart failure with preserved left ventricular systolic function. Am Heart J 1997; 134: 188–95.

Berry C, Murdoch DR, McMurray JJV. Economics of heart failure. Eur J Heart Failure 2001; 3: 283–91.

Davis RC, Hobbs FDR, Lip GYH. ABC of heart failure – History and epidemiology. Brit Med J 2000; 320: 39–42.

Erhardt LE, Cline CMJ. Organization and care of patients with heart failure. Lancet 1998; 352: Suppl II: 15–8.

Björck Linné A, Liedholm H, Israelsson B. Effects of systematic education on heart failure patients’ knowledge after 6 months. A randomised, controlled trial. Eur J Heart Failure 1999; 1: 219–27.

Keber I. Kako izboljšati obravnavo bolnikov s kroničnim srčnim popuščanjem v Sloveniji? In: Kenda MF, Fras Z, Koželj M eds. 19. Radenski dnevi – program in zbornik povzetkov. Vrhnika: Starling d.o.o., 2001: 34–5.

Joras M, Šebeštjen M, Keber I. Ambulanta za srčno popuščanje – prve izkušnje. In: Kenda MF, Fras Z, Koželj M eds. 19. Radenski dnevi – program in zbornik povzetkov. Vrhnika: Starling d.o.o., 2001: 93–5.

Ho KKL, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: The Framingham study. J Am Coll Cardiol 1993; 22: Suppl A: 6A–13A.

Rector TS, Kubo SH, Cohn JN. Patients’ self-assessment of their congestive heart failure: content, reliability and validity of a new measure, the Minesotta living with heart failure questionnaire. Heart Failure 1987; 3: 198–209.

Hanumanthu S, Butler J, Chomsky D, Davis S, Wilson JR. Effects of a heart failure program on hospitalization frequency and exercise tolerance. Circulation 1997; 96: 2842–8.

Fonarow GC, Stevenson LW, Walden JA et al. Impact of a comprehensive heart failure management program on hospitalization readmission and functional status of the patients with advanced heart failure. J Am Coll Cardiol 1997; 30: 725–32.

Holst DP, Kaye D, Richardson M, Krum H, Prior D, Aggarwal A, Wolfe R, Bergin P. Improved outcomes form a comprehensive management system for heart failure. Eur J Heart Failure 2001; 3: 619–25.

Cleland JGF, Baksh A, Louis A. Polypharmacy (or polytherapy) in the treatment of heart failure. Heart Failure Monitor 2000; 1: 8–13.

Parmley WW. How many medicines do patients with heart failure need? Circulation 2001; 103: 1611–2.

Lainščak M, Keber I, Kerbev M, Klančnik Gruden M, Horvat A, Benko D. Implementation of heart failure pharmacological treatment guidelines in hospitalised patients. 10th Alpe Adria cardiology meeting Final program & Abstracts. Vienna 2002: 40–0.

Taubert G, Bergmeier C, Andresen H, Senges J, Potratz J. Clinical profile and management of heart failure: rural community hospital vs. metropolitan heart center. Eur J Heart Failure 2001; 3: 611–7.

Fabbri G, Ambrosio G, Cafiero M et al. In-hospital outcomes of patients with heart failure by ward of admission: the TEMISTOCLE registry. Eur J Heart Failure Supplements 2002; 1: 56–7.

Preda I. Diagnosis and treatment of heart failure in different European countries: results of the »Improvement in heart failure« study. Acta Clin Croat 2001; 40: Suppl I: 71–1.

Owen A. Experience of commencing Carvedilol in elderly patients with heart failure in a routine outpatient clinic. Eur J Heart Failure 2000; 2: 287–9.

Bristow MR, Gilbert EM, Abraham WT et al. Carvedilol produces doserelated improvements in left ventricular function and survival in subjects with chronic heart failure. Circulation 1996; 94: 2807–16.

Kornowski R, Zeeli D, Averbuch M et al. Intensive home-care surveillance prevents hospitalization and improves morbidity rates among elderly patients with severe congestive heart failure. Am Heart J 1995; 129: 162–6.

How to Cite
1.
Lainščak M, Korošec B. USE OF DRUGS AND PATIENT’S QUALITY OF LIFE IN HEART FAILURE CLINIC. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];72(5). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1824
Section
Professional Article