Application of the HFDM Framework in Improving Outcomes Among Heart Failure Patients in Resource Constraint Settings

Objectives To apply the heart failure disease management (HFDM) framework while providing nonpharmacological interventions for heart failure patients in a tertiary-level hospital in northern India. Methods A pre-experimental study was carried out on 101 heart failure patients having an ejection fraction less than or equal to 40%. Participants were chosen purposively during their outpatient department visits. Baseline information about sociodemographic, clinical characteristics, exercise capacity, self-management, quality of life, medication adherence, health-related depression, and activities of daily living was obtained. Participants were provided with a one-to-one demonstration and educational session about self-monitoring and maintenance. These sessions were supplemented with one educational booklet on aspects of heart failure management, especially the individualized exercise protocol as per the New York Heart Association functional class. Telephonic encouragement was provided twice, that is, on day 15 and at 1 month. They were physically followed up at 3 months of baseline visit. Results Significant improvement was noticed in signs/symptoms like breathing difficulty ( p = .028), heart murmurs ( p = .002), activity intolerance ( p = .013), mild ascites ( p = .016), self-care adequacy ( p = .001), and quality of life ( p = .001). Conclusion Protocolized management of heart failure via the HFDM framework was effective in improvement of symptoms, self-care adequacy, and the overall quality of life of patients suffering from heart failure.