Monday , July 26 2021

"It's time for a national plan for heart failure" – Debate

This is a material for opinion. The opinions expressed here are their own authors.

The National Association of Heart Lungs conducted a survey questionnaire among its members with heart failure to indicate how to live with the disease and how to experience the care you receive. The result of the study shows that health care, unfortunately, does not reach anyone with a heart failure and that those who receive help do not achieve enough. At the same time, we know that there are great opportunities to feel better with the right treatment. It is time to introduce nationally structured concern for heart failure in health centers and hospitals in Sweden.

Heart failure is currently the most common diagnosis in Swedish medical clinics and the most common cause of inpatient care – up to every fifth in Sweden over 75 years of age. At present, about 300,000 Swedes suffer from heart failure, of which only two-thirds are given the correct diagnosis, and thus the opportunity to receive appropriate treatment. As we grow, it is a figure that is expected to increase sharply in the next fifteen years. About 50 per cent of patients with heart failure die within five years and the prognosis is often worse than in many of the most common cancers. Every fifth patient who is hospitalized for heart failure is reinstated. The large number of expensive hospital opportunities is a sign that care for various reasons misses treatment in many patients. People with heart failure are largely ill, with reduced quality of life, with several other diseases and disabilities and with great need for constant contact for care.

In a heart failure study conducted by the Swedish National Association of Cardiac Pulmonary Diseases with Heart Failure, 41 percent claim to feel desperate that they can not live a normal life with their illness. Also, the investigation shows that:

  • Half are concerned about how the disease will develop and will experience that their everyday life and social life are limited.
  • Three out of ten say they have spent more than three years before being diagnosed.
  • Half states that it's hard not to meet the same doctor every time.

It should not be like this. With structured, standardized care, more patients with heart failure will live longer and receive a better quality of life.

1. Care must be better when finding people with heart failure. A more active search in patients at risk with a blood test NT-proBNP can reduce the number of cases and find people with heart failure who might receive appropriate treatment.

2. Connect care around the patient. Patients with heart failure should be monitored for receiving heart failure in order to receive optimal treatment for physical exercises, knowledge of their disease, support for active self-care, medication and any pacemaker for heart failure. The most difficult patients need access to more advanced treatments such as a mechanical heart pump or a heart transplant. And this requires closer cooperation between home care, primary care and hospitals.

3. Knowledge. Patients with symptoms of heart failure should receive patient training and treatment plan to know what to do in the event of a worsening of the disease.

4. Implementation. For chronic heart failure of the systolic type (HF-REF) there is a great science, but no implementation of the guidelines.

5. research. Heart failure is a complicated diagnosis. In some areas there are no studies. Partial acute care in acute heart failure, when patients seek hospital care for acute deterioration, and partly so-called diastolic heart failure (HF-PEF), which more often affects women and the elderly.

If we introduce structured, standardized care in all regions, from suspected heart failure to early diagnosis and accurate treatment – through clinical centers of heart failure and registration in the registry of quality – we will reduce the need for hospital care. For society, this would mean great cost savings. It's time for a national plan.

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