Clínica Multidisciplinar de Insuficiência Cardíaca: Como Implementar

Autores

  • Irene Marques Serviço de Medicina Interna, Centro Hospitalar do Porto, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
  • Catarina Gomes Serviço de Cardiologia, Centro Hospitalar do Porto, Porto, Portugal
  • Sofia Viamonte Serviço de Fisiatria, Unidade de Prevenção e Reabilitação Cardíaca, Centro Hospitalar do Porto, Porto, Portugal
  • Gonçalo Ferreira Serviço de Medicin a Interna, Centro Hospitalar do Porto, Porto, Portugal
  • Catarina Mendonça Serviço de Medicina Interna, Centro Hospitalar do Porto, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal

DOI:

https://doi.org/10.24950/rspmi/R58/17/2017

Palavras-chave:

Cuidados Ambulatórios, Hospitalização, Insuficiência Cardíaca, Prestação de Cuidados de Saúde

Resumo

O objetivo deste artigo é fazer uma breve revisão do estado
da arte sobre clínicas de insuficiência cardíaca e divulgar
a implementação da nossa clínica, como exemplo possível
em contexto português. Assim, é revista a evidência científica
que suporta as recomendações para a implementação
dessas clínicas, a sua estrutura, os domínios que devem
abordar, as intervenções necessárias e também o impacto
associado à sua implementação. Após a revisão da escassa
evidência em território português, descrevemos a implementação
da nossa clínica multidisciplinar de insuficiência
cardíaca, a sua constituição, o seu programa estruturado
de seguimento e os principais resultados obtidos nos três
primeiros anos de atividade assistencial, nomeadamente a
redução da mortalidade e dos reinternamentos. Concluímos
que os cuidados aos doentes com insuficiência cardíaca em
Portugal podem melhorar, com a implementação de mais clínicas
como a nossa, e esperamos que este artigo estimule
esse processo.

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Referências

Ponikowski P, Voors AV, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37:2129-200.

van Riet EES, Hoes AW, Wagenaar KP, Limburg A, Landman MJ, Rutten FH. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail. 2016;18:242-52.

Rodriguez-Artalejo F, Banegas JR, Guallar-Castillon P. Epidemiology of heart failure. Rev Esp Cardiol. 2004;57:163–70.

Cowie MR, Anker SD, Cleland JG, Felker GM, Filippatos G, Jaarsma T, et al. Improving care for patients with acute heart failure: before, during and after hospitalization. ESC Heart Fail. 2014;1:110-45.

Ponikowski P, Anker SD, AlHabib KF, Cowie MR, Force TL, HU S, et al. Heart failure: Preventing disease and death worldwide. ESC Heart Failure. 2014;1:4-25.

Silva D, Gomez-Sanchez MA. Heart Failure: a new epidemic of cardiovascular disease. Acta Med Port. 2016:29;10-11.

Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418-28.

Maggioni AP, Dahlstrom U, Filippatos G, Chioncel O, Crespo-Leiro M, Drozdz J, et al. EURObservational Research Programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail. 2013;15:808–17.

Marques I, Abreu S, Bertão MV, Ferreira B, Ramos RL, Lopes J, et al. Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study. Rev Port Cardiol. 2017;36:431-8.

Ruppar TM, Delgado JM, Temple J. Medication adherence interventions for heart failure patients: a meta-analysis. Eur J Cardiovasc Nurs. 2015;14:395-404.

Albert NM, Barnason S, Deswal A, Hernandez A, Kociol R, Lee E, et al. Transitions of care in heart failure: a scientific statement from the American Heart Association. Cir Heart Fail. 2015;8:384-409.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128:1810–52.

McDonagh TA, Blue L, Clark AL, Dahlstrom U, Ekman I, Lainscak M, et al. European Society of Cardiology Heart Failure Association Standards for delivering heart failure care. Eur J Heart Fail. 2011;13:235-41.

Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, et al. Executive Summary: HFSA 2010 Comprehensive Heart Failure Guideline. J Card Fail. 2010;16:475-539.

Hauptman PJ, Rich MW, Heidenreich PA, Chin J, Cummings N, Dunlap ME, et al. The Heart Failure Clinic: A Consensus Statement of the Heart Failure Society of America. J Cardiac Fail. 2008;14:801-15.

McAlister FA, Stewart S, Ferrua S, McMurray JJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. 2004;44:810–9.

Dunbar-Yaffe R, Stitt A, Lee JJ, Mohamed S, Lee DS. Assessing risk and preventing 30-day rehospitalizations in decompensated heart failure: opportunity to intervene? Curr Heart Fail Rep. 2015;12:309–17.

Weiss BD. Health literacy and patient safety: help patients understand: a manual for clinicians. 2nd ed. Chicago: American Association Foundation and American Medical Association; 2007.

Bonow RO, Ganiats TG, Beam CT, Blake C, Casey DE, Goodlin SJ, et al. ACCF/AHA/AMA-PCPI 2011 performance measures for adults with heart failure: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Performance Measures and the American Medical Association-Physician Consortium for Performance Improvement. Circulation. 2012;59:1812–32.

Feltner C, Jones CD, Cené CW, Zheng ZJ, Sueta CA, Coker-Schwimmer EJ, et al. Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis. Ann Intern

Med. 2014;160:774–84.

Donkor A, Cleland C, McDonagh T, Hardman S. National Heart Failure Audit: 2014/2015 report da British Society for Heart Failure. National Institute for Cardiovascular Outcomes Research; 2016 [consultado 23 set 2016]. Disponível em: https://www.ucl.ac.uk/nicor/audits/heartfailure/documents/annualreports/heartfailurepublication14-15.

Comín-Colet J, Verdú-Rotellar JM, Vela E, Clèries M, Bustins M, Mendoza L, et al. Eficacia de un programa integrado hospital-atención primaria para la insuficiencia cardiaca: análisis poblacional sobre 56.742 pacientes. Rev Esp Cardiol. 2014;67:283-93.

Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995;333:1190-5.

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2016 uptade: a report from the American Heart Association. Circulation. 2015;132:000-000.

Arslan S, Erol MK, Gundogdu F, Sevimli S, Aksakal E, Senocak H, et al. Prognostic Value of 6-Minute Walk Test in stable outpatients with heart failure. Tex Heart Inst J. 2007;34:166-9.

Zotter-Tufaro C, Mascherbauer J, Duca F, Koell B, Aschauer S, Kammerlander AA, et al. Prognostic significance and determinants of the 6-Min Walk Test in patients with heart failure and preserved ejection fraction. J Am Coll Cardiol. 2015;3:459-66.

Gouya G, Hammer A, Elhenicky M, Neuhold S, Wolzt M, Hülsmann M, et al. Benefit of specialized clinics for the treatment of patients with heart failure. Eur J Intern Med. 2011;22:428-31.

Frankenstein L, Hanna F, Cleland JG. Multidisciplinary approach for patients hospitalized with heart failure. Rev Esp Cardiol. 2015;68:885-91.

Holland R, Battersby J, Harvey I, Lenaghan E, Smith J, Hay L. Systematic review of multidisciplinary interventions in heart failure. Heart. 2005;91:899-906.

Fonseca C, Brito D, Cernadas R, Ferreira J, Franco F, Rodrigues T, et al. Pela melhoria do tratamento da insuficiência cardíaca em Portugal – documento de consenso. Rev Port Cardiol. 2017;36:1-8.

Gil VM. Cuidados agudos especializados e programas estruturados de seguimento na insuficiência cardíaca. Rev Port Cardiol. 2007; 26:1131-7.

Fonseca C, Ceia F, Brito D, Madeira H. How patients are managed in Portugal. Eur J Heart Fail. 2002;4:563-6.

Ceia F, Fonseca C, Brito D, Madeira H. Tratamento da Insuficiência Cardíaca em Hospitais Portugueses: Resultados de um Inquérito. Rev Port Cardiol. 2001;20:1259-66.

Azevedo A, Pimenta J, Dias P, Bettencourt P, Ferreira A, Cerqueira-Gomes M. Effect of a heart failure clinic on survival and hospital readmission in patients discharged from acute hospital care. Eur J Heart Fail. 2002;4:353-9.

Fonseca C, Ceia F, Sarmento PM, Marques F, Covas R, Aleixo A. Implementar as recomendações na prática clínica: benefícios de uma unidade de IC aguda. Rev Port Cardiol. 2007; 26:1111-28.

Silveira C, Abreu A. Cardiac rehabilitation in Portugal: Results from the 2013-2014 survey. Rev Port Cardiol. 2016;35:659-68.

http://www.heartandstroke.com [homepage na Internet]. Canada: Heart and Stroke Foundation of Canada [consultado 23 set 2016]. Disponível em:http://www.heartandstroke.com/atf/cf/%7B99452d8b-e7f1-4bd6-a-57d-b136ce6c95bf%7D/HS_HEARTFAILURE_ZONES_EN.PDF.

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS Statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-7.

Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989; 64: 651-4.

Rector TS, Kubo SH, Cohn JN. Patient’s self assessment of their congestive heart failure. Part 2: Content, reliability and validity of a new measure. The Minnesota Living with Heart Failure Questionnaire. Heart Failure. 1987;3:198-209.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scand. 1983;67:361-70.

Borson S, Scanlan JM, Brush M, Vitaliano P, Dokmak A. The mini-cog: a cognitive “vital signs” measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000;15:1021-7.

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-98.

Piepoli MF, Conraads V, Corrà U, Dickstein K, Francis DP, Jaarsma T, et al. Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail. 2011; 13:347-57.

Desai AS, Stevenson LW. Rehospitalization for heart Failure: predict or prevent? Circulation. 2012;126:501-6.

Ficheiros Adicionais

Publicado

29-12-2017

Como Citar

1.
Marques I, Gomes C, Viamonte S, Ferreira G, Mendonça C. Clínica Multidisciplinar de Insuficiência Cardíaca: Como Implementar. RPMI [Internet]. 29 de Dezembro de 2017 [citado 28 de Março de 2024];24(4):308-17. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/766

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