Received 31 May 2005; received in revised form 4 October 2005; accepted 20 October 2005.
Abstract
Background
Nonpharmacologic clinical management practices have not been studied widely in heart failure (HF). The purpose of this survey was to describe the practices of self-identified experts in HF to identify: topics with uniformity of practice (≥75% agreement) and topics with variability in practice (no uniformity and 2 or more choices endorsed by ≥10% of respondents).
Methods and Results
An online survey of members of the Heart Failure Society of America (HFSA) actively engaged in clinical practice was conducted in Fall 2004. A total of 347 of the 1420 HFSA members in clinical practice (24.4%) responded to the survey. Of these, 321 completed the survey and 290 (90.3%) identified themselves as experts in HF. Areas in which there appears to be variability in practice include advising patients about: (1) sodium-restricted diet; (2) alcohol; (3) sexual activity; (4) increased swelling or weight gain, including use of a flexible diuretic regimen; and (5) palliative care. Providers vary in their treatment of risk factors and comorbid illnesses, the attention given to subtle losses of weight over time, beliefs about treatment adherence and ways to improve it, and opinions about the most important areas for patient education, and beliefs about health literacy.
Conclusion
Research on which to base advice for HF patients is greatly needed.
1From the School of Nursing, Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania
3Center for Health Outcomes Research and Policy, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
2College of Nursing, University of Kentucky, Lexington, Kentucky
4Center for Chronic Disease Outcomes Research, Minneapolis Veterans Administration Medical Center, Minneapolis, Minneapolis
5Denver Health Medical Center, University of Colorado, Denver, Colorado
Reprint requests: Dr. Barbara Riegel, School of Nursing, University of Pennsylvania, 420 Guardian Drive, Philadelphia, PA 19104-6096.
The opinions expressed in this article do not necessarily represent the opinion of the Heart Failure Society of America (HFSA). The authors gratefully acknowledge the willingness of the HFSA to distribute this survey to members, the survey content reviews provided by the HFSA Nursing Committee, and the support of the HFSA Care Standards Committee.
ABSTRACT