The Effect of Telephone Based Interventions in the Management of Heart Failure

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Heart disease, stroke, cancer, diabetes, and arthritis are the most common, costly, and preventable chronic diseases in the United States. Seventy percent of the total deaths in the U.S. are attributed to chronic diseases and fifty percent of that deaths are due to heart disease and stroke. Total expenditure for treatment of chronic diseases is $277 billion (Chronic Diseases and Health Promotion, 2012). Disease management is the key factor in managing these chronic conditions and improving the quality of life. Health care providers can help the patients in different ways to self-manage their disease. Telephone based interventional support is an easy and readily available tool which can be used for this purpose. Justifies the Significance of the Specialty Choice

Heart failure is one of the most prevalent forms of chronic disease in the United States, leading to high rate of mortality and morbidity. The quality of life will be severely impaired as a result of heart failure. An estimate of 5.7 million people is suffering from this disease in America. Each year 400,000 to 700,000 new cases of the heart failure are diagnosed. Approximately 280,000 deaths are reported annually due to the heart failure related complications. Heart failure imposes a heavy financial hardship on the patients, their families and the community as a whole. The annual expenditure to treat heart failure is $34 billion and it will be tripled by 2030.This predicted threefold increase is due to the aging population (Heart Failure Fact Sheet, 2012).Heart failure is defined as the inability of the heart to pump enough blood that the body needs due to weakened heart muscles. This weakness happens due to injuries caused to the heart muscles by diseases like hypertension, heart attack, and diabetes or heart murmur (Heart Failure Fact Sheet, 2012). The symptoms of heart failure are shortness of breath, chest pain, tiredness and ankle edema. Because heart failure is a progressive, chronic disease, the symptoms most often goes unnoticed. Currently this is an irreversible condition, however with effective treatment and life style modifications the symptoms can be managed (Heart Failure Fact Sheet, 2012). Synthesizes Two Articles That Relate a Nursing Action or Intervention Designed to Improve Care That is Measured in Patient Outcomes. Heart failure (HF) is the leading cause of hospital admission in Medicare age group patients. This is more than double the admission rate of pneumonia, which is the second highest reason for hospitalization. Twenty-three percent of these patients are readmitted within 30 days of discharge. The main reasons for heart failure related hospital readmission are noncompliance with medications, poor diet and lack of social support. Patients who are readmitted within a month lack adequate knowledge about the disease process. Fifty percent of readmissions can be prevented by providing patient education and follow up care (Knox & Mischke, 1999). Education begins from the moment patient steps into the acute care settings. Due to anxiety related to the admission, unfamiliar situations, fatigue and shortened length of stay, the education will not be effective. Therefore, a follow-up care from the health care provider is essential for successful management of heart failure. Telephone intervention is a simple and easy tool for providing the follow-up care and education. Effective telephone follow-up will enhance timely diagnosis and treatment, improve adherence with the treatment regimen and augment patient and health care provider satisfaction (Knox & Mischke, 1999). In an article named “Cost Effective Care- A Call Away” Slater, Phillips & Woodard (2008) describe a study regarding telephonic disease management for HF patients conducted in the New Hanover Regional Medical Center. In 2002, this hospital started a nurse administrated 24 hour telephone information service called VitaLine to educate and follow-up on HF patients. Once the HF patient...
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