Impacts of person-centred integrated chronic heart failure and palliative home care on pharmacological heart failure treatment: a substudy of a randomised trial

BMJ Supportive & Palliative Care
Rickard MarkgrenKurt Boman

Abstract

Patients with chronic heart failure (CHF) may be insufficiently treated pharmacologically. Recently, we presented a person-centred integrated Palliative advanced homecaRE and heart FailurE caRe (PREFER) strategy and compared it with usual care (control). Patients managed according to PREFER had improved health-related quality of life and markedly reduced hospitalisations compared with the control group. We hypothesised that these improvements may have been partly due to better drug treatments within the PREFER strategy. Thus, our aim in this study was to explore the management of drug treatments in the PREFER group compared with the control group. Doses and numbers of drugs and the number of patients receiving the target doses based on current guidelines were measured and compared between the groups at the start and finish of the study. The percentages of ACE inhibitors (ACEIs) or mineralocorticoid receptor antagonists (MRAs) increased, while loop diuretics decreased in the PREFER arm during the study, although the differences were not significant. Beta-receptor blockers (BBs) decreased somewhat in both groups. The number of patients treated with MRAs differed the most between groups, and increased from 10 (28%) to 15 (48%) in ...Continue Reading

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References

Aug 4, 2004·European Heart Journal·Anna Strömberg, Ulf Dahlström
Jan 6, 2005·American Heart Journal·Kamala P TamirisaTodd M Koelling
Mar 21, 2006·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Margareta BrännströmGunilla Strandberg
May 13, 2006·European Journal of Heart Failure·Kristin FalkInger Ekman
Apr 24, 2009·European Journal of Heart Failure·Tiny JaarsmaUNKNOWN Advanced Heart Failure Study Group of the HFA of the ESC
Dec 22, 2009·European Journal of Heart Failure·Asa JonssonUlf Dahlström
Jan 12, 2010·Journal of Burn Care & Research : Official Publication of the American Burn Association·Richard J Kagan, Gabrielle M Kotoski
Jul 19, 2011·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Inger EkmanKatharina Stibrant Sunnerhagen
Jul 19, 2011·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Margareta BrännströmKurt Boman
Sep 20, 2011·European Heart Journal·Inger EkmanKarl Swedberg
May 31, 2012·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Margareta Brännström, Kurt Boman

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Citations

Nov 30, 2019·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Sara WallströmAndreas Fors
Feb 28, 2020·The Cochrane Database of Systematic Reviews·Yuri NishikawaJoey Sw Kwong
Jul 10, 2017·BMJ Supportive & Palliative Care·Naghada TalabaniMargareta Brännström
Mar 16, 2021·The Cochrane Database of Systematic Reviews·Sasha ShepperdBee Wee
Sep 26, 2021·International Journal of Clinical Pharmacy·Hanna GyllenstenMalin Johansson Östbring

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