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Chronic Heart Failure

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Chronic Heart Failure

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Chronic Heart Failure

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Question:
Discuss about the Chronic Heart Failure.
 
Answer:

According to this paper, chronic heart failure is one of the prevailing severe health conditions among elderly people. Similar condition is happening to Charlie who is a 75 years old man who is obese and is suffering from ischaemic cardiomyopathy and hypertension leading him to chronic heart failure (Molloy, O’Carroll, & McMurdo, 2012). Such prevalence can be due to poor prognosis facility by the healthcare professionals. Besides this, nonadherence to the provided pharmacological interventions is also a significant barrier to the regulation of effective treatment. As per the article, only 10% of the patients suffering from chronic heart failure undertake prescribed medication in USA. Furthermore, this article undertakes analysis on the studies that determines efficacy of the medication that allows adherence in the people suffering from chronic heart failure. Additionally, keeping this as pivot, a randomized controlled trial has been conducted among the 144 adults age between 55 to 85 years and are suffering from severe heart condition. Furthermore, a concoction of both quantitative and qualitative analysis has been conducted by analysing the statistics of the sample size taken and additionally analysing the existing literature available. Moreover, the analysis has been conducted to determine the awareness level in the patients, behavioural approaches, patient care and adherence to drugs. The main resultant of the analysis was lesser adherence of the sample to the medication and needs extensive awareness and guidance towards the importance of regulation of effective treatment. Conclusively, adherence to optimal and disease-oriented medication is essential and can be achieved optimally among the patients by formulation and implementing effective strategies and imparting effective awareness regarding the importance of medication. Moreover, the meta-analysis was not possible for the conduction of the study. Additionally, heterogeneity among the interventions did not help the researchers to come upon a concrete conclusion (Krousel-Wood, et al., 2015).
This study has greater implications as it targets the patient-oriented strengths and weakness that bounds with the optimal regulation of the treatment. Charlie is a 75 year old man who is suffering from severe heart condition and there is a probability that he is not undertaking his prescribed medication on time due to certain signs and symptoms such as tachycardia, oedema, breathlessness and others. Furthermore, the quality of research is good as it determines the necessity of specific medication that causes effects on the patient, adherence to behavioural phenomenon that essentially requires selfcare and formulation of extrinsic strategies that enhances the extent of adherence. According to a recent study, patients must be informed of their condition and optimal medication for better regulation of the treatment. Adherence to medication is essential component of effective clinical practice. This provides good health, monetary stability, effective care and quality of life (Hamine, Gerth-Guyette, Faulx, Green, & Ginsburg, 2015). Additionally, another study determines that effective adherence to medication enhances self-efficacy which further maintains the equilibrium between somatic and physical trauma. Furthermore, this is conducted by providing optimal support in terms of social, cultural, psychosocial experiences, preventing the patient from depression (Maeda, Shen, Schwarz, Farrell, & Mallon, 2013).
McMurray, J. J., Adamopoulos, S., Anker, S., Auricchio, A., Bohm, M., Dickstein, K., & Zeiher, A. (2012). ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. European Heart Journal,, 1787-1847. 
 
This journal mainly provides a detailed analysis on the diagnosis and effective remedial treatment of the chronic heart failure. This paper covers each and every aspect of the diagnosis and therapeutic treatment required for the patient-oriented interventions (McMurray, et al., 2012). This paper attempts to provide an evidence-based analysis on mineralocorticoid receptor antagonists (MRAs), importance of transcatheter valve interventions, effects of ivabradine, importance of ventricular assist devices, analysis on cardiac resynchronization therapy and effect of coronary revascularization in heart failure. Besides this, detailed analysis has been conducted on various terminologies related with the heart and its degrading condition. Furthermore, this paper determines detailed analysis on various pharmacological and non-pharmacological interventions with the help of various quantitative analysis conducted among different sample sizes. The main objective of this study is to provide good quality of life and balanced lifestyle in accordance with this incurable disease. This literature review is a concoction of various sample size has been chosen over the period of time to analyse the effects remedial treatment provided with the help of angiotensin, angiotensin receptor blockers, mineralocorticosteroids, hydralazine and isosorbide, ivabradine, digoxin, omega-3 polyunsaturated fatty acids, diuretics and many others. Additionally, analysis has been conducted on the provision of non-surgical methods such as various cardiac implantable devices such as implantable cardioverter-defibrillator, cardiac resynchronization therapy, pace makers and many others. Furthermore, the main findings of the analysis undertake efficient and prolonged usage of these interventions on the basis of the requirement by the patient. Conclusively, this paper provides a detailed analysis on the diagnosis and treatment of the severe heart condition. The remedial treatment must be a patient-oriented concoction of pharmacological and non-pharmacological interventions. The probable limitation of the paper is vast study collection of the data without any one concrete conclusion. Additionally, no optimal analysis on the specific sample size for each study (McMurray, et al., 2014).
The strength of the paper is vast collection of the data that cover every possible aspect of the analysis required for the detailed study on the prevailing severe heart conditions that assist healthcare professionals to formulate effective interventions for the patient. Furthermore, the quality of the research is up to the mark and the paper has been critically analysed. The resultant of this paper must be practiced efficiently in the clinical practicing by the healthcare professionals. An analysis conducted by Troughton et al., 2014, determines that the concoction of pharmacological and non-pharmacological interventions is the best possible methodology of providing effecting treatment to the patient (Troughton, et al., 2014). Furthermore, an analysis conducted by Ambrosy et al., 2014, determines that effective imparting of the treatment to the patient suffering from heart condition has led to decrease in the extent of hospitalization in various hospitals among different countries. The probable recommendations will require optimal imparting of the patient-oriented treatment by the skilled and experiences cardiac nurses in order to conduct effective clinical practicing. Furthermore, optimal reporting and documentation must be incorporated in the routine treatment by undertaking effective formulation and regulation of change of shift report among different healthcare professionals working together (Ambrosy, et al., 2014).  
Strömberg, A., Mårtensson, J., Fridlund, B., Levin, L.-A., Karlsson, J.-E., & Dahlström, U. (2003). Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: Results from a prospective, randomised trial. . European Heart Journal,, 1014-1023.
This journal determines the probable implications of follow up on selfcare, morbidity, mortality and other factors in a clinic run by nurses among the heart patients. As per the article a large percentage of the people are suffering from chronic heart failure and the survival rate of the patients suffering from such chronic heart conditions is very less (Strömberg, et al., 2003). Moreover, high morbidity is one of the prevailing reasons of severe heart conditions among the patients. High morbidity has led to high mortality rate due to suffering from severe heart chronic conditions. In addition to this, inefficiency also prevails among the nurses while conducting the effective follow up. Such inefficiency leads to inadequate and incompatible compliance with the required interventions in terms of pharmacological and non-pharmacological treatment. Furthermore, imparting of the awareness in the patient and regular follow up leads to decrement in the hospitalization of the patient, increases awareness among patient leading to enhanced quality in the life of the patients suffering from critical conditions (Feltner, et al., 2014). In order to conduct the analysis on the effectiveness of the follow up by the nurses, a 12 months randomised trial has been conducted in different hospitals of New York. A total of 161 patients were undertaken for the conduction of the program. These patients were primarily suffering from heart disease and other associated illness or maladies such as pulmonary congestion, dementia or others. Furthermore, a quantitative analysis has been undertaken with the help of questionnaire to determine the extent of awareness and selfcare among the patients. Additionally, the data has been collected regularly at the baseline of 3 months and 12 months. The collected data was statistically analysed with the help of t-test and Whitney U test. The resultant at the end of the analysis determined that lesser hospitalization of the patient and decrement in the morbidity occurred after the 12 months of the interventions. Additionally, effective follow up led to lesser hospitalization of the patients after 3 months only and enhancement in the selfcare has also been recorded. Conclusively, effective follow ups by the nurses increases the awareness level leading to increment in the selfcare, lesser morbidity and mortality rate. In addition to this, certain limitations also prevail also prevails in this study. Smaller sample size and predetermined setting of the location, time period, geographical are and others for the assessment has affected the resultant even after the adoption of the randomization. Besides thee limitations, the strength of this study was the selection of sample size from different locations. This brought heterogeneity in the resultant. Furthermore, the quality of research is up to the mark and has covered each and every aspect of required for the detailed analysis on the extent of follow up by the nurses (Stewart, et al., 2015). Moreover, the resultant of this paper must be implemented effectively in the regular clinical practice in order to increase the extent of remedial treatment. Furthermore, a group of multidisciplinary or multiagency team working together to provide a patient-oriented follow up will lead to much enhanced results (Glogowska, et al., 2015).
 
Bibliography
Ambrosy, A. P., Fonarow, G. C., Butler, J., Chioncel, O., Greene, S. J., Vaduganathan, M., & Gheorghiade, M. (2014). The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. . Journal of the American College of Cardiology,, 1123-1133.
Feltner, C., Jones, C. D., Cené, C. W., Zheng, Z. J., Sueta, C. A., Coker-Schwimmer, E. J., & Jonas, D. E. (2014). Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis. . Annals of internal medicine, , 774-784.
Glogowska, M., Simmonds, R., McLachlan, S., Cramer, H., Sanders, T., Johnson, R., & Purdy, S. (2015). Managing patients with heart failure: a qualitative study of multidisciplinary teams with specialist heart failure nurses. . The Annals of Family Medicine,, 466-471.
Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. . Journal of medical Internet research,.
Krousel-Wood, M., Elizabeth, H. O., Joyce, C., Rachael, R. U., Dornelles, A., Webber, L. S., & Whelton, P. K. (2015). Differences in cardiovascular disease risk when antihypertensive medication adherence is assessed by pharmacy fill versus self-report: the Cohort Study of Medication Adherence among Older Adults (CoSMO). Journal of hypertension,, 412.
Maeda, U., Shen, B. J., Schwarz, E. R., Farrell, K. A., & Mallon, S. (2013). Self-efficacy mediates the associations of social support and depression with treatment adherence in heart failure patients. International journal of behavioral medicine, , 88-96.
McMurray, J. J., Packer, M., Desai, A. S., Gong, J., Lefkowitz, M. P., Rizkala, A. R., & Zile, M. R. (2014). Angiotensin–neprilysin inhibition versus enalapril in heart failure. New England Journal of Medicine,, 993-1004.
Stewart, S., Chan, Y. K., Wong, C., Jennings, G., Scuffham, P., Esterman, A., & Carrington, M. (2015). Impact of a nurse?led home and clinic?based secondary prevention programme to prevent progressive cardiac dysfunction in high?risk individuals: the Nurse?led Intervention for Less Chronic Heart Failure (NIL?CHF) randomized controlled study. European journal of heart failure, , 620-630.
Troughton, R. W., Frampton, C. M., Brunner-La Rocca, H. P., Pfisterer, M., Eurlings, L. W., Erntell, H., & Dahlström, U. (2014). Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization: an individual patient meta-analysis. European heart journal,, 1559-1567. 

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