Self-management in heart failure: where have we been and where should we go?

Abstract

Chronic conditions such as heart failure (HF) place a tremendous strain on patients, their families, the community, and the health care system because there are no real “cures”. Adding to the burden are longer life expectancies and increased numbers of people living with multiple chronic conditions. Today, whether engaging in a health-promoting activity, such as exercise, or living with a chronic disease such as HF, the individual is responsible for actively managing day-to-day activities, a concept referred to as self-management. Self-management emerged as the cornerstone for chronic care models and multidisciplinary disease-management strategies in chronic illness care. Moreover, self-management has been prioritized as a central pathway for improving the quality and effectiveness of most chronic HF care. Adherence to self-management is vital to optimize the treatment outcomes in HF patients, but implementing chronic disease self-management (CDSM) strategies and identifying the difficulties in self-management has proved to be a challenge. Understanding both where we have been and the future direction of self-management in HF care is not only timely, but a crucial aspect of improving long-term outcomes for people with HF and other chronic diseases.

Keywords:

• self-management
• heart failure
• chronic disease
• self-care
• disease management

Acknowledgements

I would like to acknowledge Martha Shively, PhD, RN for her ongoing enthusiasm and support for my dissertation topic and for lending her expertise in behavioral research and content.

I am grateful for the involvement of my dissertation chair, Christine Kasper, PhD for her timeless energy and expert comments on this and other manuscripts over the past several years.

I extend my appreciation to Ben Y Tseng, PhD and Marilynne Tseng, BSN, RN for their editorial comments and revisions in preparing this manuscript.

I would also like to thank Barbara Gray, MA for her eagle eye and editorial expertise.

Funded by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development, project # 04-252.

Disclosure

The author declares no conflicts of interest.