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Pharmacy Times
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Small steps can accumulate and have a big impact on patients’ lives
In health care, the phrase “follow your heart” holds an even deeper meaning for patients with heart failure. When a patient has heart failure, their heart cannot efficiently pump blood to meet the body’s needs.1 This can be a result of weakened pumping ability or thickening of the lower left chamber, which reduces its blood-holding capacity and causes a buildup of fluid in the lungs and extremities. This fluid buildup and decreased blood to the body can cause uncomfortable symptoms such as swelling of the feet, ankles, legs, and abdomen; sudden weight gain; shortness of breath; coughing and wheezing; inability to sleep or breathe while lying down; lightheadedness; fatigue; confusion; and depression.2 Pharmacists must understand their patient’s heart failure stage, class, and symptoms to provide them with the best education for a longer and healthier life.3
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Pharmacists can help patients implement lifestyle changes to improve their quality of life. The first step is to explain the diagnosis to patients while providing the empathy they need; these changes can be difficult. It is important to ensure that patients recognize they know themselves best when it comes to how they feel.
Melissa Russo, PharmD, is director of clinical education and program implementation at Rite Aid. In her role, Melissa and her team provide education and support to Rite Aid’s field leaders and more than 1750 store locations to ensure successful outcomes of all clinical programs and initiatives.
Second, patients with heart failure must understand the importance of tracking their symptoms daily (assessing for swollen legs or feet, weighing themselves to monitor for weight gain, and keeping a record of energy level, coughing/wheezing, etc) so that it is easy to identify if they are beginning to feel worse and may need help from their health care team.4 Patients should always watch for new or changing symptoms and should eliminate or reduce smoking or alcohol intake, which could worsen symptoms and add to the discomfort. Additionally, educating patients about identifying urgent symptoms or knowing when emergency care is needed could save their lives.
A healthy diet, light exercise, and medication adherence also play a vital role in improving patients’ outcomes. Patients with heart failure should aim to have a diet that includes fruits, vegetables, whole grains, low-fat dairy products, nuts, and legumes. They should avoid sodium, red meat, sweets, and high levels of sugar.4 It is important to be mindful of packaged convenience foods because they tend to have a lot of salt added to extend the shelf life of the product. In addition, light exercise, such as walking at a moderate pace for a few minutes a day, helps strengthen the heart.4
Finally, medication management is critical for prolonging the patient’s life, enhancing heart function, and reducing symptoms. Pharmacists play a crucial role in providing patients with the necessary tools for adherence and educating them about the importance of following their medication regimen. By adhering to their medication schedule, patients can live longer, breathe easier, reduce swelling, and improve their energy levels.5 Most patients with heart failure are prescribed multiple medications. Pharmacists should review each medication’s indication and the correct dose to take daily, and they should ensure the patient knows to partner with the pharmacist if they are planning to take any supplements or OTC medications in order to avoid interactions. This is a great time for pharmacists to recommend a pill box or reminder alarm system to keep all medications organized. It is also important to note that some medications can be expensive, and a patient may need assistance in finding a coupon or alternative.
Every lifestyle change counts, and accumulating small changes can make a big difference. Although there is no cure for heart failure, there are numerous ways to manage the condition with consistent healthy habits. Pharmacists can suggest smartphone apps, daily sheet trackers, self-check plans, and educational websites to patients to help them stay educated and keep track of their symptoms.5 There are approximately 6.2 million adults with heart failure in the US, and pharmacists are the most accessible health care provider. Pharmacists need to take the initiative and assist patients with their medication adherence consultations, provide immunizations for prevention, and educate them about lifestyle changes, including the management of other health conditions and stress-relief tactics.6 Active partnerships and ongoing learning between patients and their health care team will lead to the best outcomes.
