Congestive Heart Failure Management in the Elderly

Current Research: Thesis and Questions

The focus of the current research is associated with the management of congestive heart failure (CHF). The thesis statement is the following: although healthcare professionals have managed to develop superior management and therapeutic processes for CHF, advanced strategies are still needed for minimizing hospital readmissions and ensuring that elderly patients lead quality lifestyles. It has been hypothesized that there was a connection between such variables as healthcare providers’ efforts of implementing effective management strategies for addressing CHF and rates of elderly patient readmissions. This means that the superior evidence-based strategies may play an important role in reducing or preventing hospital readmissions of CHF patients (Kripalani, Theobald, Anctil, & Vasilevski, 2014). Research questions involved in the study encompass several components such as specific CHF-targeted interventions, gaps in current CHF management, the availability of evidence-based therapies, and so on. The key research question is the following: what evidence-based interventions, practices, and therapies can be integrated for managing CHF in elderly patients and preventing their readmissions to hospitals?

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Article Review

During the search of the relevant and up-to-date literature to support and guide the current study, such keywords as congestive heart failure in elderly, CHF management, CHF prevention, CHF evidence-based practice, and CHF readmissions were used. The following study was found to review:

Hancock, H., Close, H., Mason, J., Murphy, J., Fuat, A., de Belder, M., …Hungin, A. (2012). Feasibility of evidence-based diagnosis and management of heart failure in older people in care: A pilot randomized controlled trial. BMC Geriatrics, 12(70), 1-10.

In this study, researchers conducted a pilot randomized controlled trial that included a random sample of patients from thirty-three healthcare facilities in North-East England. 28 patients ended up being eligible for the study, among which 25 elderly patients completed their assessment and follow-ups for the study and 3 patients died due to heart failure. The mean age of the enrolled patients was 83.6 years, and 43% of participants were male (Hancock et al., 2012). At six months of the implemented management interventions, 21% of the subjects achieved optimal treatment, which facilitated the improvement of their condition (Hancock et al., 2012). The study concluded that on-site heart failure services developed on the basis of evidence could be feasible for the management of such chronic heart conditions as CHF, ventricular systolic dysfunction, and others. A key finding of the research was associated with the possibility to optimize the evidence-based practices and procedures to manage older patients’ heart conditions without the need of having a negative influence on their quality of life, which presents an array of positive implications for practice.

Moreover, the value of the study was also reflected in the breaking of the misconception that older people are usually unwilling and unable to participate in research that involves complex methods of illness diagnosis and management. It can be concluded that the optimization of medication necessary for the management of heart failure is possible and can be tested again in larger scale trial. When it comes to the disadvantages of the study, several issues can be pointed out. The first issue (a gap in the research) is associated with a relatively small sample size of patients; by conducting a similar study on a larger scale, researchers may achieve better validity and provide conclusions based on broader evidence (McDonagh, Peterson, Raina, Chang, & Shekelle, 2013). The second problem is associated with limitations that the stakeholder group presented. It was evident that the management of care homes, residents, and healthcare providers had not been particularly engaged in the study, which limited the findings. Therefore, it can be concluded that a study on a similar topic and with the use of similar methods should be implemented again but on a larger scale and with the involvement of more elderly patients diagnosed with CHF and other heart conditions. Moreover, it is essential to account for such variables as patient mortality since it was an issue in Hancock et al.’s (2012) research.

References

Hancock, H., Close, H., Mason, J., Murphy, J., Fuat, A., de Belder, M., …Hungin, A. (2012). Feasibility of evidence-based diagnosis and management of heart failure in older people in care: A pilot randomized controlled trial. BMC Geriatrics, 12(70), 1-10.

Kripalani, S., Theobald, C. N., Anctil, B., & Vasilevskis, E. E. (2014). Reducing hospital readmission: Current strategies and future directions. Annual Review of Medicine, 65, 471-485.

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McDonagh, M., Peterson, K., Raina, P., Chang, S., & Shekelle, P. (2013). Avoiding bias in selecting studies. Web.

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