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老年人心力衰竭 第 1 部分:疾病状态评估和生活方式干预。

Heart Failure in Older People Part 1: Disease State Review and Lifestyle Interventions.

机构信息

Northeastern University, Boston, Massachusetts.

出版信息

Sr Care Pharm. 2024 Sep 1;39(9):325-332. doi: 10.4140/TCP.n.2024.325.

Abstract

The care for patients with heart failure (HF) has evolved greatly over the past decade. While new guidelines have provided more clarity on categorization and staging, and novel agents have been approved for use, there are still questions surrounding the optimal strategies as they relate to diet and exercise. Additionally, overall health care costs have increased for patients, driven in part by medication therapy. Given the myriad comorbidities associated with the diagnosis of HF, senior care pharmacists are positioned to positively impact the care for patients with HF, regardless of setting. As the guidelines continue to evolve, addressing a wider spectrum of the disease, including iron deficiency, mental health, and pain, so must the pharmacist's role in caring for patients with HF. Senior care pharmacists engaged in the management of older people with HF must be especially attuned to the unique and individualized care each patient needs, offering guidance and education in balancing treatment modalities across all aspects of care. In this three-part series, we will explore a number of areas central to the management of HF. This first section will focus on the cost of treatment, pathophysiology, and non-pharmacologic management. Series two and three will address guideline-directed medication therapy and special population management, respectively.

摘要

在过去的十年中,心力衰竭(HF)患者的护理有了很大的发展。虽然新的指南在分类和分期方面提供了更明确的指导,并且有新的药物被批准使用,但在与饮食和运动相关的最佳策略方面仍存在一些问题。此外,由于药物治疗,患者的整体医疗保健费用增加。鉴于与 HF 诊断相关的多种合并症,高级护理药剂师无论在何种环境下,都有能力积极影响 HF 患者的护理。随着指南的不断发展,涵盖更广泛的疾病谱,包括缺铁、心理健康和疼痛,药剂师在 HF 患者护理中的作用也必须随之改变。参与管理 HF 老年患者的高级护理药剂师必须特别关注每位患者独特的个体化护理需求,在治疗方式方面提供指导和教育,以平衡护理的各个方面。在这个三部分系列中,我们将探讨与 HF 管理相关的多个领域。这第一篇将重点介绍治疗成本、病理生理学和非药物治疗管理。第二和第三部分将分别讨论指南指导的药物治疗和特殊人群管理。

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