Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement

被引：38

作者：

Stewart, Simon ^{[1
]}

Riegel, Barbara ^{[2
]}

Boyd, Cynthia ^{[3
]}

Ahamed, Yasmin ^{[4
]}

Thompson, David R. ^{[5
]}

Burrell, Louise M. ^{[6
]}

Carrington, Melinda J. ^{[7
]}

Coats, Andrew ^{[8
]}

Granger, Bradi B. ^{[9
]}

Hides, Julie ^{[10
]}

Weintraub, William S. ^{[11
]}

Moser, Debra K. ^{[12
]}

Dickson, Victoria Vaughan ^{[13
]}

McDermott, Cressida J. ^{[4
]}

Keates, Ashley K. ^{[4
]}

Rich, Michael W. ^{[14
]}

机构：

[1] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Ctr Res Excellence Hlth Serv Res Reduce Inequal H, Level 5,215 Spring St, Melbourne, Vic 3000, Australia

[2] Univ Penn, Sch Nursing, Room 335 Fagin Hall,418 Curie Blvd, Philadelphia, PA 19104 USA

[3] Johns Hopkins Univ, Ctr Aging & Hlth, Mason F Lord Bldg,7th Floor,Ctr Tower, Baltimore, MD 21224 USA

[4] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Level 5,215 Spring St, Melbourne, Vic 3000, Australia

[5] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Ctr Heart & Mind, Level 5,215 Spring St, Melbourne, Vic 3000, Australia

[6] Univ Melbourne, Austin Hlth, Dept Med, Level 7,Room 10,Lance Townsend Bldg, Heidelberg, Vic 3084, Australia

[7] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Ctr Primary Care & Prevent, Level 5,215 Spring St, Melbourne, Vic 3000, Australia

[8] Monash Univ, Monash Warwick Alliance Off, Bldg 3A,Clayton Campus,Wellington Rd, Clayton, Vic 3800, Australia

[9] Duke Univ, Sch Nursing, 307 Trent Dr, Durham, NC 27710 USA

[10] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Ctr Musculoskeletal Res, Level 1,631 Stanley St, Woolloongabba, Qld 4102, Australia

[11] Jefferson Univ, Christiana Care Hlth Serv, Ctr Heart & Vasc Hlth, Suite 1070,4755 Ogletown Stanton Rd, Newark, DE 19713 USA

[12] Univ Kentucky, Ctr Biobehav Res Self Management Cardiopulm Dis, Coll Nursing, 527 Coll Nursing Bldg, Lexington, KY 40536 USA

[13] NYU, Coll Nursing, 433 First Ave Room 742, New York, NY 10010 USA

[14] Washington Univ, Sch Med, Div Cardiovasc, 660 S Euclid Ave,Campus Box 8086, St Louis, MO 63110 USA

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2016年 / 212卷

基金：

英国医学研究理事会; 美国国家卫生研究院;

关键词：

Heart failure; Multimorbidity; Person-centred perspective; Multidisciplinary management; DISEASE MANAGEMENT PROGRAMS; RANDOMIZED CONTROLLED-TRIAL; 30-DAY READMISSION RATES; CLINIC-BASED MANAGEMENT; ASSOCIATION TASK-FORCE; SELF-CARE INTERVENTION; OLDER-ADULTS; NONCARDIAC COMORBIDITIES; GUIDED CARE; FOLLOW-UP;

D O I：

10.1016/j.ijcard.2016.03.001

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Multimorbidity in heart failure (HF), defined as HF of any aetiology andmultiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. Methods: To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions. From these data we describe a clinical framework, comprising five key steps, to potentially improve historically poor health outcomes in this patient population. Results: We identified five key steps (ARISE-HF) that could potentially improve clinical outcomes if applied in a systematic manner: 1) Acknowledge multimorbidity as a clinical syndrome that is associated with poor health outcomes, 2) Routinely profile (using a standardised protocol - adapted to the local health care system) all patients hospitalised with HF to determine the extent of concurrent multimorbidity, 3) Identify individualised priorities and person-centred goals based on the extent and nature of multimorbidity, 4) Support individualised, home-based, multidisciplinary, case management to supplement standard HF management, and 5) Evaluate health outcomes well beyond acute hospitalisation and encompass all-cause events and a person-centred perspective in affected individuals. Conclusions: We propose ARISE-HF as a framework for improving typically poor health outcomes in those affected by multimorbidity in HF. (C) 2016 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：1 / 10

页数：10