Chapter

Nonpharmacological management

Lynda Blue and Yvonne Millerick

in Oxford Textbook of Heart Failure

Published on behalf of Oxford University Press

ISBN: 9780199577729
Published online July 2011 | e-ISBN: 9780199697809 | DOI: http://dx.doi.org/10.1093/med/9780199577729.003.0046

Series: Oxford Textbooks

Nonpharmacological management

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Managing heart failure (HF) is not an easy task: the numbers of patients are large and increasing, and many patients have complex needs. This presents a challenge not only to patients and their caregivers but also to health care systems and health care professionals. Patients are asked to take multiple pharmacological agents that often require adjustment; are expected to make lifestyle changes; and a growing number of patients are now being considered for device therapy. At hospital discharge, few patients receive lifestyle and self-management advice in written form and it is therefore not surprising that many patients with HF have poor knowledge about their condition and its management.

Over the last decade, various guidelines have been published on the management of chronic HF. The guidelines have primarily concentrated on pharmacological treatment (and more recently, device therapy) and only briefly address lifestyle advice and self-care management strategies.

Several trials of specialist HF management programmes which adopt a multidisciplinary approach have shown that self-management strategies lead to an improved quality of life. A multidisciplinary approach has also been shown to reduce hospitalizations and mortality.

Optimal management of HF requires not only best practice in pharmacological management but also appropriate education strategies, practical advice, and caring support to enable patients and their caregivers to achieve the best possible quality of life, without offering unrealistic expectations of cure. It is important not only that patients and their caregivers are given the opportunity to take greater control of managing their condition, but also that health care professionals should not underestimate the critical role they have in empowering their patients. Much of the present chapter is based on expert advice, rather than robust evidence.

Chapter.  6954 words. 

Subjects: Cardiovascular Medicine

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