Heart failure patients getting an hour of individualized education about diet and medications before they leave the hospital take better care of themselves at home reducing their risk of rehospitalization or dying in the next six months, say researchers at the University of Michigan Cardiovascular Center.It used to be that half of those diagnosed with heart failure would die within five years. Today there are many treatments and strategies that have been shown to help people with heart failure live longer, but patients often don’t stick to them when they go home. Studies show that up to two-thirds of hospital admissions for heart failure patients are due to non-compliance.
So a team of doctors and nurses at the University of Michigan evaluated education strategies with 223 patients whose hearts were weakened by previous heart attacks, clogged arteries, high blood pressure, heart muscle infections or other conditions. Patients were randomized to get either a one-on-one session with a nurse educator before they went home from the hospital or the standard pre-discharge brochures and fliers.
After six months, the researchers observed that the individualized education time resulted in a 34 percent lower risk of being readmitted to the hospital or death due to heart failure. The research, led by Dr. Todd Koelling, was presented at the Scientific Sessions of the American Heart Association in Florida last week.
Mickey Gilbert is an education nurse with the Heart Failure Program at Hackensack University Medical Center in Hackensack, New Jersey, who was not involved with the Michigan study. She says patients who’ve gone through an intensive education program at Hackensack do a complete turnaround and don’t end up back in the hospital. Gilbert says it’s something nurses should be doing automatically for patients in the hospital setting.
"I really think it’s important to teach people not just what to do but also the whys of what to do,"said Gilbert.
In the study at the University of Michigan patients in the one-on-one sessions were taught what heart failure is, how it’s caused, and the major symptoms. They also got a lesson on the various medications and lifestyle changes that can improve their prospects for living with the disease. Patients were taught the importance of reducing sodium intake to less than 2000 milligrams and how to spot water retention.
"People don’t truly understand how much sodium content is in processed foods, especially elderly people," said Gilbert. "And patients are sent home on 7 different medications and they have a hard time organizing them and taking them correctly," she added.
The Michigan researchers hope their study will encourage hospitals to hire nurse educators who can visit patients individually and talk to them about why it’s important to follow their treatment regimen at home. Most insurers don’t pay for costs associated with a readmission of heart failure patients within 30 days of a previous discharge from the hospital. Preventing readmissions could save hospitals money and help save patient lives.
The researchers for this study received funding from the Quality Care Research Fund of the American Medicine and Managed Care Forum, which is supported by companies that make heart failure medications.
