Heart Failure Management Plan

This assignment focuses on developing a comprehensive management plan for a hypothetical patient named Mr. Charlie suffering from heart failure. It emphasizes the importance of patient education, self-care strategies, and lifestyle modifications. The plan includes recommendations for dietary restrictions (limiting salt intake), increased physical activity to manage weight, cessation of smoking and alcohol consumption, and travel considerations due to breathlessness. Additionally, it highlights the significance of vaccinations, specifically yearly influenza and a single pneumococcal immunization.

Annotated
Bibliography

TABLE OF CONTENT
PART 1............................................................................................................................................3
Annotated Bibliography..............................................................................................................3
PART 2............................................................................................................................................4
Justification of the choice of sources..........................................................................................4
PART 3............................................................................................................................................6
Recommendations for clinical practices.....................................................................................6
REFERENCES................................................................................................................................7

PART 1
Annotated Bibliography
Gorthi, J. & et. al. (2014). Reducing heart failure hospital readmissions: A systematic review of
disease management programs. Cardiology Research. 5. 126-138.
Heart failures (HF) is referred to be a chronic situation that is directly affecting a large set
of Americans where the enumerated ratio depicts near about 5.7 million people suffering from it.
It is however due to an increasing number of aged population that is in turn resulting into a rising
ration of heart diseases that has also resulted in a raised cost to manage the HF and is expected to
increase more by the year 2030 (Gorthi & et. al., 2014). It is basically due to an intensified
readmission rate of the patients suffering from heart related diseases where 25% of them are
being readmitted at a gap of 30 days and 50% are readmitted at 6 months. These facts and
findings have in turn formed the base of this survey where a systematic review of the disease
management programs have been studied over here. This investigation has been done in support
of the enactment named Patient Protection and Affordable Care Act. This in turn have
constituted the national Hospital Readmissions Reduction Program (HRRP) to some major
efforts for the evolution of HF disease management programs (DMPs). This is with a
fundamental sense of reducing the readmissions of patients who are often hospitalized for HF.
Guo, R., Pittler, M., & Ernst, E. (2008). Hawthorn extracts for treating chronic heart failure.
Cochrane Database of Systematic Reviews. 2008(1). 1-31.
It is together in support an increasing concern of HF where this study is carried to assess
the role of Hawthorn extract to treat the chronic HF in patients. Wherein, Hawthorn is referred to
be one of the most renowned herbal medicinal product in Europe and US where it is also being
traded in some outer nations to be used as a prescribed medicine. It is basically used as an oral
treatment where it is hereby presented as an alternative treatment for the patients suffering from
a chronic state of HF. This study is therefore conducted with a prompt objective of evaluating
both its advantages and ill impact when compared with other medicinal drugs or placebo so as to
treat the chronic state of HF in patients suffering with heart related diseases (Guo, Pittler &
Ernst, 2008). Randomised controlled trials (RCTs) methods were involved to carry out a meta
analysis research with the help of both secondary and primary sources of data collection. Herein,
MEDLINE, the Cochrane Library, EMBASE, CISCOM, CINAHL, and AMED as literatures

were searched with no restraint on the language of the publication. It was with a prime assistance
of 2 reviewers along with 13 trials to meet out the inclusion criteria of this study. It was also in
support of 8 trials that involved 632 patients suffering from chronic HF where it has lastly
represented the Hawthorn treatment to be more useful in comparison to placebo.
McMurray, J. J. & et. al. (2012). ESC guidelines for the diagnosis and treatment of acute and
chronic heart failure 2012. European Heart Journal. 33. 1787-1847.
This paper has highlighted another key concern of sudden cardiac death also termed as
SCD that is referred to be amongst the most debilitating complication. Such life threatening
disease of HF has together challenged the medical science for a longer time period. It is however
in accordance to the recent guidelines that have suggested a prompt utilisation of Implantable
Cardioverter Defibrillator also known as ICD (McMurray & et. al. 2012). Wherein, this is
referred to be a primary prevention of SCD that is mainly in concord to the New York Heart
Association (NYHA). This is basically to handle the HF cases of both class II and III of NYHA.
Herein, this research paper has critically assessed the information that is implicating the
suggestions given in the guideline. Where it is in contradiction to the current guideline, most of
the trials involved to carry out research on this subject matter till now have depicted a likely role
of ICD to prevent SCD in the case of HF in the class II of NYHA. Although, amongst all
conducted trials that were found to have a substantial function of ICD in HF of type III was
unpowered that further indicated the need of more trials for confirming the usage of ICD for the
prevention of SCD occurs in the type III of HF.
PART 2
Justification of the choice of sources
This section is especially to justify the above chosen source for summarization where
there results are together been evaluated and critiqued. In context to which, the foremost source
has reflected a systematic review of disease management programs with a major consideration of
reducing the readmissions in hospitals for heart failure. It was based upon a systematic review of
randomized control trial method so as to reduce the impact of readmission of patients in hospitals
due to the cases of heart failure (Wu & et. al., 2012). This involved the scrutinization of almost
all type of monitoring approaches such as home care, structured telephonic support, outpatient
clinical interventions along with invasive and non invasive telemonitoring. However, all this

disease management programs (DMP) were found to exist with contradictory results with a
special consent of home care and outpatient clinic interventions where both of these indicated
certain limitations. This involved two major extents of cost and availability where
telemanagement has in turn displayed a potent outlook where it has the capacity to reach out a
large set of audience at a reasonable price structure (Rees & et. al., 2013). The most
strengthening prospect of this source was its meta-analysis review where 11 non invasive
telemonitoring studies have been articulated along with invasive telemonitoring surveys that
have shown the power to decrease the hospitalization rate of patients suffering from HF. It is
therefore on referring to the clinical practice represented in this source is a flexible nature of HF
DMPs where it must reflect the potentiality of meeting all individualistic needs of specific
patient's.
On referring to yet another undertaken source that reflected a study that was carried to
compare two distinct medicinal treatments of HF. It is where the comparison was duly made
among a herbal extract called Hawthorn with a medicinal drug called placebo. However, this
study was duly carried out to ascertain both benefits and drawbacks of Hawthorn extract as an
oral treatment for chronic HF. It was done by conducting 14 trials to meet out all inclusion
criteria by using hawthorn as a subsidiary conventional treatment (Murray & et. al., 2009). It
together represented a meta analytical approach where 10 out of total 14 trials have involved 855
patients suffering from chronic heart failure. It is thereby on associating the findings obtained
from this study with that to the given case script of Mr Charlie where he has been found to suffer
from high blood pressure along with the symptoms of breathlessness, etc. All these diseases can
be effectively treated with the help of hawthorn extracts as compared to placebo and has hereby
defined to be a beneficial selection to survey the management of Charlie's condition.
Lastly, the chosen source indicated a study that was carried out to ascertain the measures
for the diagnosis and treatment of chronic HF by referring to ESC guidelines (Faris & et. al.,
2006). Where, on relating the acquired findings of this survey with the given case scenario of
Charlie, it has not depicted any such effective measure to handle his concerning situation. It is
due to a critical condition of Charlie that comes under the class III of NYHA and required more
trials to reach to a considerable result.

PART 3
Recommendations for clinical practices
It is in accordance to the present case study that is based upon a 75 year old man named
Charlie who was also overweighted and was suffering from some major heart related diseases.
This together involved some other major complications in breathing along with cardiac
arrhythmia and peripheral oedema, etc., (Takeda & et. al., 2012). Charlie was together diagnosed
to suffer from anaemia, high blood pressure and cardiomyopathy before two years where he is
recently dealing with an increased discomfort where he is resultantly found to suffer from severe
HF as well. It is thereby on the basis of above three sources selected to summarise the
information for a proper administration of Charlie's condition, there exists some below
mentioned recommendations for the same-
 Patient education and self care is referred to be an important consideration over here
where a strict dietary and exercise advise must be given to Mr Charlie where he should be
together suggested adopting a changed lifestyle with some significant improvements.
 It is where Mr Charlie must be completely restricted from smoking and alcohol
consumption with likely diet and fluid intake where his salt intake should not increase by
2-3 g each day.
 An encouraged sense of exercising to reduce some weight is together advisable where Mr
Charlie is referred to be overweighted (Sagar & et. al., 2015).
 Also, air plane travel should be restricted for Mr Charlie who is suffering from
breathlessness and in huge requirement of oxygen with in- flight medical aid while
travelling in air.
 Immunization is also referred to be a major concern for patient's like Mr Charlie where
they must be given a yearly influenza vaccination along with a single pneumococcal
immunization.

REFERENCES
Faris, R. F. & et. al. (2006). Diuretics for heart failure. Cochrane Database of Systematic
Reviews. 2006(1). 1-23.
Gorthi, J. & et. al. (2014). Reducing heart failure hospital readmissions: A systematic review of
disease management programs. Cardiology Research. 5. 126-138.
Guo, R., Pittler, M., & Ernst, E. (2008). Hawthorn extract for treating chronic heart failure.
Cochrane Database of Systematic Reviews. 2008(1). 1-31.
McMurray, J. J. & et. al. (2012). ESC guidelines for the diagnosis and treatment of acute and
chronic heart failure 2012. European Heart Journal. 33. 1787-1847.
Murray, M.D. & et. al. (2009). Factors associated with exacerbation of heart failure include
treatment adherence and health literacy skills. Clinical Pharmacology and Therapeutics.
85. 651-658.
Rees, K. & et. al. (2013). Dietary advice for reducing cardiovascular risk. Cochrane Database of
Systematic Reviews. 2013(12). 1-113.
Sagar, V. A. & et. al. (2015). Exercise-based rehabilitation for heart failure: Systematic review
and meta-analysis. Open Heart. 2. 1-12.
Takeda, A. & et. al. (2012). Clinical service organisation for heart failure. Cochrane Database of
Systematic Reviews. 2012(9). 1-158.
Wu, J-R. & et. al. (2012). Effect of a medication-taking behavior feedback theory-based
intervention on outcomes in patients with heart failure. Journal of Cardiac Failure.
18(1). 1-9.