Patients with heart failure are increasing, follow-up care is lacking. They are looking for a way in VFN

Experts are talking about the increase in heart failure cases like an epidemic. At Prague’s General Faculty Hospital (VFN) they realize how difficult it is for patients to return to normal life, and therefore decided to start helping them. As part of the monthly program called Znovu do života, they offer patients rehabilitation, psychological support, education in the field of self-care with regard to the disease in question, or the possibility of social support.

“The main goal of the project is to offer patients with heart failure after the end of their stay in the hospital the option of comprehensive intensive rehabilitation, thanks to which they will receive a certain transitional degree between hospitalization and home care. This will reduce the risk of their re-hospitalization,” says the professor Jan Bělohlávek, primary II. internal clinics of cardiology and angiology of the 1st Faculty of Medicine, UK and VFN, who is the author of the project.

What does the program help with?

According to him, discharged patients are not sick enough to stay in the hospital, but at the same time, they often need relatively intensive care, which is too expensive for them and is not covered by insurance companies.

“People with heart failure are usually limited in performance or movement, which we try to help them with through intensive rehabilitation. We also educate them about the disease as such, so that they learn to live with it as quickly as possible and can at least get closer to life before hospitalization. Alternatively, so that they know where to ask for help at home, for example. We also have to work with patients’ families, for whom the situation is also often new and difficult,” explains Iveta Svobodováa cardiologist from the same clinic.

Patients more than welcome help

So far, ten patients have been selected who have received and are receiving the mentioned care. According to cardiologist Svobodová, they more than welcomed the possibility of care.

“I know from my own experience and the experience of other patients that one of the most important things after returning from the hospital is to still feel the support of the doctors. It is the period when the patient feels most insecure. The possibility of psychological consultation is also a huge help, because when a person finds himself on the edge of life and sometimes even beyond it, it is difficult to come to terms with it. Often mainly for the immediate surroundings of the patient,” he says Marie Frydmanováthe director of the patient organization Znovu do života, who participates in the project and who herself suffered a cardiac arrest a few years ago.

The Back to Life organization also covers 80 percent of the costs associated with follow-up care. The rest is up to the patient. Whether the person concerned is willing to participate financially was also one of the criteria for acceptance into the program.

The nurse visits the patients at least twice

And what exactly does the monthly program look like? A nurse visits the patient once while still in the hospital. “After that, it is at least twice during the rehabilitation stay in the aftercare facility, after the stay, the patient has a check-up in our outpatient clinic. He also has at least one visit to a nutrition specialist, psychotherapist and social nurse in a hospital or rehabilitation facility at the beginning of his stay and one visit to our outpatient clinic after the end of his stay.” Dr. Svobodová describes.

Health insurance companies would also have to contribute to the expansion

For now, the project only concerns VFN patients, but in the future experts would like it to be extended to other workplaces as well. “First of all, we wanted to verify whether such an intervention is feasible at all. In the future, of course, it would be ideal if this rehabilitation program became a regular part of care for patients with heart failure, however, this will require the cooperation of all cardiology departments, and especially health insurance companies,” points out the mayor of Bělohlávek.

“In the near future, we will evaluate the first 10 patients, with the fact that we would like to continue the project for the time being with the funds of the patient organization for other patients, if it were possible to massively expand the project and involve other medical facilities, then it would be necessary to finance such care from health insurance “ Dr. Svobodová adds.

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What is heart failure?

Heart failure is a condition where the heart cannot supply enough blood to the body. Thus, it cannot ensure a sufficient supply of oxygenated blood to the body’s organs. The three main symptoms of heart failure are shortness of breath, fatigue and swelling – e.g. ankles, etc. Other symptoms include e.g. persistent cough, loss of appetite, nausea, increased heart rate, etc.

In the adult population, the prevalence of heart failure reaches 1-2 percent of adults and increases with age. From about one percent in those under 55 to more than 10 percent in those 70 and older.

According to experts, patients with heart failure have been increasing enormously in recent years.

“In 2018, there were almost 300,000 patients. In 2022, however, we are approaching half a million patients with a reduced ejection fraction. And on top of that, we have another 700,000 patients with heart failure with a preserved ejection fraction. So in a comprehensive view of heart failure, we’re epidemiologically ahead of diabetes because it’s hovering at 1.1 million patients and we’re at about 1.2 million patients. It’s a huge population burden and we have to deal with it,” said the professor in the summer Miloš Taborskymember of the committee of the Czech Cardiology Society and head of the 1st internal clinic of the Faculty of Medicine of the University of Warsaw and the Olomouc University of Applied Sciences.