Government pub may be helpful CHF resource
More aid for counseling than drugs
Heart failure clinicians looking for publications to add to their libraries may want to check their collections to see if they have the Quick Reference Guide for Clinicians, Number 11: Heart Failure — Management of Patients with Left-Ventricular Systolic Dysfunction.
The 21-page booklet was produced by the Agency for Health Care Policy and Research in 1994.
The reference opens with a detailed algorithm for evaluation and care of patients with heart failure. Each station of the flowchart is open-ended, such as marking a point of initial pharmacological management. Subsequent pages then break down the different treatment milestones into topics for further discussion.
Useful for patient education
Pharmacologic management includes use of ACE inhibitors, diuretics, and digoxin but does not include the latest recommendations about beta-blockers or the conclusions of the Digitalis Investigation Group that was published three years after this guide became available.
For this reason, caregivers may find this booklet more useful to guide other areas of patient management such as counseling and patient education. There is a table of suggested topics for patient, family, and caregiver education and counseling. This subject is subdivided into general counseling, prognosis, activity recommendations, dietary recommendations, medications, and importance of compliance.
But even though many of the newer findings about drug therapy are not included (because they occurred after the manual was printed) students may find it helpful to have the lists of different types of ACE inhibitors and diuretics in one table. The authors also explain the decision making involved in revascularization.
The guide does not address heart failure that occurs despite normal ventricular systolic performance or disease that happens as a result of surgically correctable valvular disease.
The Quick Reference Guide for Clinicians is available by calling AHCPR at (800) 358-9295 and asking for publication number 94-0613, or by writing to the AHCPR at its publications clearinghouse: P.O. box 8547, Silver Spring, MD 20907.
The larger Clinical Practice Guideline is still available through the Government Printing Office for $6.95. Call (202) 512-1800 and ask for publication number 94-0612.
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