Heart failure is on the rise, but follow-up care for patients is lagging behind
The Back to Life project tests follow-up therapy for patients
They can no longer manage as much as they used to, they need a lot of medication, and often still don’t feel well at all – returning from the hospital is often very difficult for patients with heart failure. At the same time, however, they must quickly learn to live with their health condition, otherwise they risk its deterioration and further hospitalization. Cardiologists are therefore trying out a new form of care as part of a project called Back to Life, which aims to help sick people get through the critical period after returning from the hospital. As part of the month-long program, patients receive rehabilitation, psychological support, education in self-care with regard to their specific illness, and social support options. The authors of the project hope that it will shorten the time it takes for patients to return to normal life and reduce the risk of further hospitalization. In the future, similar follow-up care should become standard.
Cases of heart failure in the Czech Republic are skyrocketing, and experts are seriously talking about an epidemic. Heart failure is one of the most common causes of hospitalization in people over 60. “The main goal of the project is to offer patients with heart failure the possibility of comprehensive intensive reconditioning after their stay in the hospital, which will provide them with a transitional stage between hospitalization and home care. This will reduce the risk of their rehospitalization,” says Prof. Jan Bělohlávek, MD, PhD, head of the Second Internal Clinic of Cardiology and Angiology at the First Faculty of Medicine of Charles University and the General University Hospital, who is the author of the project. According to him, discharged patients are not so ill that they
Care and education are provided by trained healthcare professionals who visit patients at home. “People with heart failure are usually limited in their performance or movement, which we try to help them with through intensive rehabilitation. We also educate them about the disease itself so that they can learn to live with it as quickly as possible and get as close as possible to the life they had before hospitalization. Alternatively, so that they know where to ask for help at home, for example. We also have to work with the families of patients, for whom the situation is often new and difficult,” says Dr. Iveta Svobodová, a cardiologist at the Second Internal Clinic of Cardiology and Angiology of the First Faculty of Medicine of Charles University and the General University Hospital, who is also involved in the Back to Life project.
Her words are confirmed by patients who have found themselves in a similar situation. “From my own experience and that of other patients, I know that one of the most important things after returning from the hospital is to still feel the support of doctors. This is a period when patients feel most uncertain. The possibility of psychological consultation is also a huge help, because when a person finds themselves on the brink of life and sometimes beyond, it is difficult to come to terms with it. This is often especially true for the patient’s immediate family,” says Marie Frýdmanová, director of the patient organization Znovu do života (Back to Life), which is participating in the project and who herself suffered cardiac arrest several years ago.
The pilot phase of the project is currently underway, and the authors plan to include a total of ten patients. Eighty percent of the costs associated with follow-up care are covered by the patient organization. “The vast majority of people greatly appreciate this opportunity because they learn how to do everything correctly, and it helps them return to normal life,” says Prof. Bělohlávek. According to him, a complete evaluation of the project will take place by the end of the year, but it is already clear that similar care should be available to other patients with heart failure. “For now, the project is limited to our facility and selected patients. We wanted to verify whether such an intervention was even feasible. In the future, it would of course be ideal if this reconditioning program became a standard part of care for patients with heart failure, but this will require the cooperation of all cardiology centers and, above all, health insurance companies,” concludes Prof. Bělohlávek.
Experts estimate that there are about 330,000 patients with heart failure living in the Czech Republic, with approximately 40,000 new cases each year. Cardiologists predict that by 2030, they will be treating about 450,000 patients in the Czech Republic. In addition to the General University Hospital, Boehringer Ingelheim is also participating in the Back to Life project.