A CRITICAL STEP TO ACHIEVE IMPROVED OUTCOMES
Medical professionals are often frustrated when providing recommendations to patients in order to manage their condition only to find that their advice has not been followed resulting in patients who have not improved, or have even become worse. In fact, research has shown that, on average, less than half of all patients take their medication properly and less than 10 percent of patients make the lifestyle changes recommended by their physicians.(1) In February, FL based Infinity Homecare began a comprehensive patient empowerment program to improve care for congestive heart failure patients. Preliminary results have shown that the program significantly improved patient outcomes including drastically reduced re-hospitalization rates.
Cardiovascular disease is the leading cause of death in the United States and accounts for 1 in every 2.8 deaths.(2) However, an astounding 80% of this cardiovascular disease could be prevented by making dietary and lifestyle modifications. Therefore, any successful cardiac program must focus on interventions that can empower patients to create positive lifestyle and dietary changes which will significantly lower their risk factors. The American Heart Association has published an article titled “Interventions to Promote Physical Activity and Dietary Lifestyle Changes for Cardiovascular Risk Factor Reduction in Adults” that provides evidence based recommendations on the most effective strategies for successfully implementing physical activity and lifestyle interventions among adults.
The following is a summary of effective evidence based strategies as reported in the aforementioned AHA article (3):
In a study testing interventions to promote weight loss, those who frequently recorded their weight achieved twice the weight loss than those who only recorded weight infrequently.
PROVIDING INDIVIDUALIZED EDUCATION
In a study comparing non-individualized self-help manuals vs. individualized motivational matched materials, those who received motivational matched materials were able to achieve a 50% increase in physical activity when compared to those receiving non-individualized self-help manuals.
FOSTERING INITIATION AND MAINTENANCE OF BEHAVIOR CHANGE
Infinity HomeCare has instituted these core evidence based strategies into their CHF Patient Empowerment Program and have had great success with a reduction in their CHF related re-hospitalization rate decreasing from 44% in 2013 to less than 2% on the 70 patients that have been admitted to their new program. The Bradenton Herald has also recently published an article on a military veteran who was recently admitted to the program and made a remarkable recovery.
(1.) American Academy of Family Physicians. Patient Self-Management Support Talking Points
(2.) Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, Hailpern SM, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O’Donnell C, Roger V, Sorlie P, Steinberger J, Thom T, Wilson M, Hong Y; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008; 117: e25–e146.
(3.) Artinian N.T., Fletcher G.F., Mozaffarian D.;American Heart Association Prevention Committee of the Council on Cardiovascular Nursing Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. Circulation. 122 2010:406-441.