DocWire News Editors

DocwireNews

Self-care involves maintenance (e.g., diet, exercise, tobacco cessation, sleep habits), monitoring (e.g., recognizing signs and symptoms, listening to body), and managing (e.g., taking medication, calling the healthcare provider). However, self-care is often poor in patients with heart failure (HF).While patient education is necessary to discuss self-care, it is not always sufficient, said Barbara Riegel, PhD, RN, FAAN, of the University of Pennsylvania, who discussed this topic during a session titled, &ldquo;Self-Care in HF: Where the Emphasis Needs to Lie&rdquo; at the American College of Cardiology Annual Scientific Session. Ninety-nine percent of self-care is managed by the patients and their caregivers, not the doctors, said Dr. Riegel. Self-care can improve outcomes, so why don&rsquo;t patients perform self-care?&ldquo;We&rsquo;ve learned that there are a lot of factors that are impairing patients&rsquo; abilities to perform self-care,&rdquo; said Dr. Riegel. Most patients with HF (98%) have two or more coexisting chronic conditions. In addition, treatment regimens are often complex. Other symptoms may thwart self-care goals, such as impaired cognition, physical limitations, low energy, depression, and anxiety. Patients may also have inadequate knowledge and skills, as well as economic constraints and poor access to healthcare.Studies have found that self-care declines as the level of comorbidity rises, probably because of a decrease in self-efficacy. Attitudes drive the priority given by patients to various self-care behaviors, and fragmented self-care instruction leads to poor integration of self-care and self-care skill deficits, she said.Patients with HF take, on average, 10 medications per day, most of which require multiple doses. Approximately three-quarters of older adults with multiple chronic conditions are at risk of therapeutic competition&mdash;a treatment recommended for one condition that may adversely compete with another condition, according to a 2014 study by Lorgunpai et al. Physicians should also recognize that they contribute to poor patient self-care, said Dr. Riegel.&ldquo;We have incredibly high expectations of our patients. We ask them to develop a level of knowledge that is not common in the general population,&rdquo; she said. &ldquo;We put them on a regimen that they don&rsquo;t want to partake in [and] they aren&rsquo;t familiar with.&rdquo; Patients also face fragmented instructions from multiple providers, as well as polypharmacy and therapeutic competition.Next, Dr. Riegel discussed symptom perception. Patients were asked about their experience with certain symptoms: 80% experienced fatigue, but just 48% recognized it had something to do with their HF condition. In addition, 93% of patients experienced shortness of breath, but 59% recognized it as related to HF.&ldquo;They can&rsquo;t manage their symptoms because they&rsquo;re not even interpreting [them] correctly,&rdquo; she said.Dr. Riegel suggested that for patients with HF, physicians consider de-prescribing their regimen. Ask patients how quickly they recognize their symptoms and what they do to manage them, then assess symptom pattern characteristics to identify potential problems. Promote self-care early, before the window of opportunity closes, she concluded.

Bradley Marder, MD

Joel M. Topf, MD, FACP

Gout Studies: Transplant Waitlisting and Bone Erosion

NKF Spring Clinical Meetings 2025

Jayme Locke, MD, MPH

The Promise of Xenotransplantation

Leah Lawrence

Real-World Data Backs Invasive DFS as Surrogate Endpoint for OS in EBC

HR Breast Cancer

Latest News

Physicians Need to Encourage Self Care in Patients With HF

ACC 2019 Conference

Self-care involves maintenance (e.g., diet, exercise, tobacco cessation, sleep habits), monitoring (e.g., recognizing signs and symptoms, listening to body), and managing ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe