Current state of heart failure management by home health-care professionals

Abstract

Background: This study aimed to clarify the status of disease management during home visits for patients with heart failure (HF). Methods: In this cross-sectional study, questionnaire surveys were conducted with health-care professionals employed by home-visit nursing stations in Kochi Prefecture. Data were collected by postal mail between May and June 2019. A 13-item questionnaire was created based on the disease management items in the “2017 Guidelines for Diagnosis and Treatment of Acute and Chronic Heart Failure.” The Chi-square test and logistic regression analysis were used for the statistical analyses. Results: The analysis set comprised data collected from 144 nurses and therapists. Regarding disease management for patients with HF, 99.1% of the nurses examined the “status of blood pressure measurement” during home visits. Regarding therapists, 100% confirmed the “status of blood pressure measurement” as well as “signs and symptoms of heart failure.” The items “status of medication use,” “body weight measurement and changes,” “infection prevention and vaccination,” “psychiatric symptoms (anxiety and depression),” and “cognitive function” were confirmed significantly more frequently by nurses than by therapists. After adjusting for confounders, compared with therapists, “body weight measurement and changes” (adjusted odds ratio [aOR]: 4.58; 95% confidence interval [CI]: 1.11–18.87) and “psychiatric symptoms (depression and anxiety)” (aOR: 7.25; 95% CI: 1.39–37.70) were confirmed significantly more frequently by nurses than by therapists. Conclusion: The present findings suggest that, compared with therapists, nurses attempt to gain a greater overall understanding of the status of patients with HF in disease management.