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Heart failure patients in need of early education

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Heart failure nurses should target recently hospitalised or high-risk patients to implement heart failure management programmes as early on as possible, according to the latest guidance.

The European Society of Cardiology guidelines address both acute and chronic heart failure for the first time, putting particular emphasis on adherence to treatment and patient self-management.

They recommend that heart failure nurses provide comprehensive education to help patients manage their condition at home.

This includes advice on fluid restriction, diet and exercise, the importance of medication compliance and how to recognise worsening symptoms.

They also recommend that all heart failure patients are offered counselling, and that those with end-stage disease have access to specialist palliative care services.

Annie O’Donaghue, heart failure nurse specialist at Guy’s and St Thomas’ NHS Foundation Trust in London, said: ‘These guidelines mirror NICE guidance and underpin the clinical importance of what is already being done in practice.’

She added: ‘Evidence shows that if patients are concordant with medications, modify their lifestyles and can recognise the symptoms of heart failure, they can improve their quality of life and prognosis.’

According to research, between 40% and 80% of heart failure patients do not adhere to their prescribed medications and non-pharmacological treatments. Data from the 2007 EuroHeart survey found that many patients either misunderstand or do not remember receiving advice on self-care management.

Jan Oliver, heart failure nurse specialist at Darlington PCT, said: ‘A lot of heart failure patients are elderly and some have cognitive impairment.

‘An important part of the heart failure nurse role is to explain and then reiterate what they have to do and why. You may have to repeat yourself but it is vital for these patients to fully understand and be compliant with self-managing their care.’

The guidelines were launched last week at the European Society of Cardiology congress in Munich, Germany.

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