Heart Failure Patients: User Journey (1)
The heart failure patient journey starts with the physical checkup and clinical tests to determine the congestion of their heart. Hospitalization is crucial for monitoring the condition of the patent and getting the proper medication. It is also important to schedule follow-up appointments with physicians to monitor the condition and to avoid re-hospitalization.
Heart Failure Patients: User Journey
- Congestion is crucial in detecting the healthcare conditions of people suffering from heart failure.
- Congestion is not that easy to detect especially if the patients only have minor symptoms.
- Congestion can affect the functionality of the heart and can lead to poor health conditions.
- Getting physical examination is crucial to determine the level of heart congestion.
- Doctors usually check the patients' heart rate, blood pressure, weight, dyspnea, and edema.
- Patient's weight, symptoms of obesity, sleeping problems, sleep-disordered breathing (SDB), CHF-associated comorbidity are some of the conditions that indicate the progress of heart failure.
- Doctors also verify the patient's dyspnea, orthopnea, systemic edema, third heart sound, and jugular venous pressure to determine the functionality of the other organs.
- Other clinical tests used to get the clinical congestion score include the Stevenson classification, the Lucas score, the Rhode score, the EVEREST score, and the Gheorghiade score.
- However, the EVEREST score gives the most reliable results.
- Test are done frequently to verify the status of the patient.
- The patients are usually submitted to a lung ultrasound (LUS), as it gives the fastest and most reliable results, to determine whether the BNP or NT-proBNP hormones are necessary for the patient.
- Chest X-rays are also done frequently to monitor the heart condition of the patient.
- When a patient is diagnosed with heart failure, they go through 3-phases: the transition phase of the left ventricular remodeling, the plateau phase, and early death.
- Admitting patient that suffer from heart failure to the hospital is necessary to observe their condition.
- The multimodal congestion assessment is done upon admission, during the decongestion treatment, and before discharging the patient.
- Clinical test are frequently done throughout the decongestion phase of the patient. Some of the most common tests include the EVEREST score, the quantitative dyspnea evaluation, plasma volume estimation, ultrasounds, echocardiography, and liver and kidney biomarkers. The patient is also regularly given varying doses of the BNP or NT-proBNP hormones.
- According to multiple studies, regularly monitoring the patient by using LUS and echocardiographies can reduce the risk of death and their re-hospitalization
- LUS tests are done to monitor the diuretic or vasodilator therapy to determine when the patient can be discharged.
- After getting discharged, the patient is required to visit a cardiologist, a general practitioner, or a HF nurse within 2 weeks of their discharge.
- This practice is important to avoid re-hospitalization or death.
- Clinical tests like looking at biological biomarkers, implantable hemodynamic monitoring, and/or lung bioimpedance monitoring are performed on the patients to supervise their health conditions after their discharge.
- If the patient's heart congestion starts getting worse, they need to visit their physicians to get an assessment.
- Based on studies, almost 35% of patients are getting re-hospitalized due to their heart failure problem.
- Healthcare institutions have started introducing patient-centered telemedicine to reduce the risk of hospital re-admission.
- Telemedicine allows a 24/7 patient monitoring by trained nurses and physicians in order to guide the patient in their recovery and prevent emergencies.
- The champion trial, used to treat hemodynamic congestion, gives better results to HF patients and also shows that it can reduce the re-hospitalization rate of patients.
- The patients who are re-admitted to the hospital are more susceptible to complications and dying.
- Male patients, older patients, and psychologically unstable patients are more at risk of a re-hospitalization. Some other factors include avoiding a proper check-up by their physicians, the prescription of prognostic medications, and the consumption of alcohol.
- Patients suffering from sleep-disordered breathing (SDB) are also at risks of re-hospitalization.