Community Knowledge And Burden Of Heart Failure: An Analysis Of Public HF Awareness Week Meetings In Canada

Abstract:

BACKGROUND: Heart failure (HF) is a common cause of acute hospital admission, especially in the elderly. Success with education that changes patient behaviour can further reduce hospitalizations and quality of life. Broad education programs have been developed to reduce risk factors that lead to HF, promote adherence with proven therapies, identify early warning signals of HF decompensation, and promote early intervention. The Canadian Heart Failure Network (CHFN) has promoted a Heart Failure Awareness week in February over the last 5 years with local educational meetings for patients, relatives and the public.
METHODS AND RESULTS: Of the total people who attended these meetings for the first time, 439 completed an anonymous survey of HF knowledge and self-management on arrival and before the start of the meeting. The median age was 64yrs with 50% male and 50% female. 48% of attendees were patients with HF, 22% were caregivers of HF patients, and 30% were neither of the above but were "interested". The mean duration of HF, or as a caregiver for HF, was 4.4yrs. When asked to identify the most important topics on HF, the priority rank order was: how HF impacts health; medications; nutrition, including salt and fluid restriction; activity/exercise; coping with stress/anxiety. The source of most information on HF for patients came from heart professionals (73%) and media (13.8%). 71.3% had access to the internet but only 35.8% described themselves as having "a lot" of competence using the internet. 81% answered that they read food labels for salt content. Among attendees who identified themselves as patients with HF, 26% reported no symptoms, 40% reported slight, 27% reported marked, and 6% reported major symptoms. 64% knew the cause of their HF, 90% had a reliable weight scale at home, 51% monitored their weight daily, and 92% answered that they took their medications as prescribed "all the time". When asked on a scale from 1 low to 10 high, 63% of HF patients were confident in looking after their HF at a level of 8-10 but only 22% rated their general health at 8-10.
CONCLUSION: Many patients and caregivers look for education beyond clinic appointments. The attendees represent those with an interest to learn more about HF but some important gaps were identified. Current internet education programs for HF patients and caregivers may not access the majority of the target audience who are less competent with that medium. While education remains central for HF awareness and management, more research is required for coping with stress and anxiety and nutrition including whether the reading of food labels translates into altered habits since HF admissions remain high.