Navigation Links
Counseling May Not Help Heart Failure Patients Comply With Rx
Date:9/22/2010

By Jenifer Goodwin
HealthDay Reporter

TUESDAY, Sept. 21 (HealthDay News) -- Living with heart failure can put a patient on overload. The rigors of having to lose weight, strictly limit salt intake, exercise and take a half-dozen or more medications lead many people to disregard their doctor's orders.

Chicago researchers thought that a combination of group counseling and reading materials on how to manage heart failure would improve adherence to medical recommendations, but their new study finds otherwise. The two-pronged approach was no more effective than simply giving patients reading materials, they found.

Though disappointing, their data did suggest that counseling might be beneficial for lower-income patients, though not more affluent ones, said lead study author Lynda H. Powell, a professor of preventive medicine at Rush University Medical Center.

"This is a health disparities issue," Powell said. "In Chicago, we have three blacks for every white hospitalized for heart failure. Being more attentive to some of the special needs of some of these underserved populations is certainly in order."

For the study, published in the Sept. 22/29 issue of the Journal of the American Medical Association, 902 patients with mild to moderate heart failure were divided into two groups. One group took part in 18 self-management meetings over the course of a year and also received educational materials; the other group were sent tip sheets on managing the condition and received follow-up calls after each mailing to make sure they understood what they'd read.

The patients' average age was 64. About 40 percent were racial or ethnic minorities, while about 52 percent had an annual family income of less than $30,000. Many patients also had other conditions, including depression, diabetes and lung disease. On average, patients took seven different medications.

During the group sessions, patients received disease-management advice, such as how to read ingredient labels; tips for coping with stress, such as deep breathing; tricks for remembering to take pills; and the importance of talking about heart failure with family and friends, the idea being that social supports help in making and maintaining lifestyle changes, Powell said.

Over two to three years of follow-up, 163 people (40.1 percent) were hospitalized for heart failure or died in the self-management counseling group vs. 171 (41.2 percent) of those who received reading materials alone.

In addition, no significant differences were noted in hospitalizations for any cause, quality of life, blood pressure or body mass index .

In patients with congestive heart failure, the heart no longer pumps enough blood to meet the body's needs for blood and oxygen. Common causes include coronary artery disease, past heart attacks, atrial fibrillation and hypertension, according to the American Heart Association.

Medication can help control symptoms, which include fatigue, shortness of breath and swollen feet and ankles. And lifestyle changes can help keep the condition from worsening, experts say.

Yet many patients don't heed their doctor's instructions. Previous research has shown 30 to 60 percent of patients don't take medications as prescribed, while 50 to 80 percent don't make the lifestyle changes needed, according to background information in the study.

"Adherence to medications and lifestyle changes for heart failure are atrocious," Powell said. "When you get to people of lower socioeconomic status, the rates of non-adherence are the highest."

Dr. Gregg Fonarow, American Heart Association spokesman and professor of cardiology at the University of California, Los Angeles, said the study is well done, but the findings should not be interpreted to mean nothing can be done to help people manage heart failure.

Other research has shown that more intensive interventions, including help from physicians who specialize in heart failure and specially-trained nurses, can help patients stick to healthier lifestyles and medications.

Telemedicine, including sensors that can monitor vital signs and heart pressure and transmit data to physicians, is also promising, Fonarow said.

Especially for those with mild symptoms, making the lifestyle changes and sticking to prescribed medications can go a long way, but all of the steps required can be overwhelming, said Dr. John Cleland, a cardiologist at Hull York Medical School at the University of Hull in England, who wrote an accompanying editorial.

"The potential for information overload is exceedingly high," Cleland said. "Education and motivation are required to improve outcomes because it is the patients with rather mild symptoms who may not feel the need to bother that benefit most from intervention. Patients who have severe symptoms have often reached the end of the road and then there is little we can do for most."

More information

The American Heart Association has more on heart failure.

SOURCES: Lynda H. Powell, Ph.D., chair, department of preventive medicine, Rush University Medical Center, Chicago; Gregg Fonarow, M.D., American Heart Association spokesman and professor, cardiology, University of California, Los Angeles; John G. F. Cleland, cardiologist, Hull York Medical School, University of Hull, Kingston-upon-Hull, England; Sept. 22/29, 2010, Journal of the American Medical Association


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Male breast cancer in family leads to high perception of risk, low likelihood of genetic counseling
2. Counseling increased mammography use among low-income women with health insurance
3. College Equalizer Takes College Counseling Beyond the Status Quo to Help Adult Learners Find the Best School
4. Web- and phone-based counseling work well to quit smoking with Chantix
5. More Couples Turn to Phone Counseling in Times of Stress
6. Weight Counseling Plus Drug Helps Women Quit Smoking
7. Prenatal Healthcare Providers Inconsistent In Weight Gain Counseling
8. Avatar Meets Marriage Counseling; Take Imago Therapy for a Test Drive
9. Pennsylvania to Observe Problem Gambling Awareness Week; Remind Residents of Available Counseling and Treatment Services
10. Counseling Suicidal Clients by Andrew Reeves
11. Plavix, Heartburn Drug Safe to Take Together: Study
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Counseling May Not Help Heart Failure Patients Comply With Rx
(Date:6/26/2016)... North Carolina (PRWEB) , ... June 26, 2016 , ... ... release of a new product that was developed to enhance the health of felines. ... for centuries. , The two main herbs in the PawPaws Cat Kidney Support ...
(Date:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs ... College of Mohs Surgery and to Dr. Russell Peckham for medical and surgical dermatology. ... treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern Californian, Dr. Omkar ... M.D from the David Geffen School of Medicine at UCLA. He trained in Internal ... complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had ...
(Date:6/24/2016)... ... , ... A recent article published June 14 on E Online ... on to state that individuals are now more comfortable seeking to undergo not only ... calf and cheek reduction. The Los Angeles area medical group, Beverly Hills Physicians (BHP) ...
(Date:6/24/2016)... ... 24, 2016 , ... The Pulmonary Hypertension Association (PHA) learned ... receive two significant new grants to support its work to advance research and ... by recognizing patients, medical professionals and scientists for their work in fighting pulmonary ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the addition of the ... to 2022" report to their offering. ... financial data derived from varied research sources to present unique ... on the market during the next five years, including a ... markets, regional and country level analysis. The report provides a ...
(Date:6/23/2016)... -- Bracket , a leading clinical trial technology and ... platform, Bracket eCOA (SM) 6.0, at the 52 nd ... 2016 in Philadelphia , Pennsylvania.  A demonstration ... of its kind to fully integrate with RTSM, will be ... is a flexible platform for electronic clinical outcomes assessments that ...
(Date:6/23/2016)... and BOGOTA, Colombia , June 23, 2016  Astellas today announced the establishment of ... Farma Brasil as the company,s second affiliate in Latin America . ... ... Manager of Astellas Farma Colombia ... ...
Breaking Medicine Technology: