A Melbourne-based general physician and researcher says this week’s Heart Failure (HF) Awareness Week offers an opportunity to get the message out about the benefits of early intervention and the role nurses can play in managing the condition.
Associate Professor Ingrid Hopper, who performs clinical duties at Alfred Health and research as part of Monash University’s School of Public Health and Preventive Medicine, says that although heart failure doesn’t have a cure, there are plenty of treatment options available to assist those living with the condition.
“There is huge potential to improve people’s quality of life, keep them out of hospital and maintain independent living if it is diagnosed early, treated with appropriate medications and lifestyle changes,” Associate Professor Hopper says.
“In Heart Failure Awareness Week, it is important to get the message out that although there is no cure for heart failure (HF), early detection, medical therapies, and lifestyle changes can help people living with HF to manage their condition well and lead productive and fulfilled lives.”
HF has been labelled as an “epidemic”, and an estimated 500,000 Australians are living with the condition, including around 10% of those aged 70 or older.
It occurs when the heart can’t pump enough blood to meet the body’s nutritional needs, because the heart is unable to fill with enough blood, or its pumping action isn’t strong enough, or both.
Associate Professor Hopper completed her PhD on heart failure, and says that while her PhD focused on therapeutics, it is actually clinical care that has most significantly altered her understanding of how treatment can improve the condition of those living with the disease.
“It’s a privilege to walk with patients during their heart failure journey,” she says.
“From meeting patients during the first hospital admission at diagnosis terribly unwell, seeing them as outpatients still unwell, scared and overwhelmed, then improving as their therapies work and their confidence in managing themselves improves, and their lives get so much better. Then at the other end, helping people make decisions at the end of their life.”
Concurrently, Associate Professor Hopper is especially keen for Nurse Practitioners and HF nurse specialists to play a greater role in managing the disease, pointing out that there is a strong evidence base demonstrating that “nurse-led titration of heart failure medications can reduce hospital admissions.”
“The value of nurses in delivering education and care in heart failure cannot be understated,” she says.
“In our institution, patients with heart failure can be followed up early within a week of discharge in a nurse-pharmacist led clinic, or they are contacted at home by phone by nurses from our Hospital Admission Risk Program (HARP). This nursing care makes a huge difference in patients’ confidence and helps prevent them bouncing back into hospital.”
For health care professionals who want to more actively improve their understanding of HF, Associate Professor Hopper says that it’s important to realise that HF can have a “subtle” presentation and taking a pro-active approach to identifying symptoms is the best way to proceed.
Shortness of breath particularly when lying down or during exertion, fluid retention around the ankles or abdomen, and fatigue are among the symptoms, with Associate Professor Hopper noting that HF can be “debilitating” as well, restricting “people’s ability to walk, work and care for themselves.”
“Encourage patients to be aware of heart failure symptoms and speak with their GP if they notice symptoms or feel something isn’t quite right,” she says.