A recent study published in the Journal of Cardiovascular Nursing suggests diabetes management as part of treatment plan in patients admitted for heart failure (HF) and diabetes. Findings suggest that diabetes management in patients with HF and diabetes is not prioritised. A collaborative and integrative approach among healthcare professionals of all relevant teams could help in better management.
HF-related index admission (n=542; 370 only HF; 172 HF and diabetes) in 2 UK-based hospitals between April 2011 and March 2012 were retrospectively reviewed. Examination of medical records was conducted for 72 patients with HF and diabetes and ejection fraction <45%, with special emphasis on their management. 14 patients with HF and diabetes were interviewed to understand their view of inpatient care.
Within 12 months of index admission, patients with HF and diabetes, vs those with HF alone, were more likely to attend accident and emergency (P<.01) and re-admitted to hospital as an emergency. Among 72 patients with HF and diabetes, 85% were reviewed by HF specialist nurse, whereas only 29% were reviewed by a diabetes specialist nurse. Some interview respondents believed that their admission could have been prevented by increased monitoring and contact with health care providers. Patients suggested better communication among different care team members and increased communication with healthcare providers. Need for clearly written instructions/discharge summary and explanations before discharge was expressed by this patient cohort.
Authors believe optimisation of diabetes management in patients with HF is an effective way of reducing frequent re-admissions and improving patient outcomes.
