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Heart Health

04 December 2019

For people with heart failure, loneliness can mean worse care

Loneliness is the most important predictor of whether patients adopt lifestyle advice or not.

Fewer than one in 10 heart failure patients follows lifestyle treatment recommendations, and a new study suggests that loneliness is a major reason why.

Polish researchers assessed 475 heart failure patients' compliance with a regimen of restricting salt and fluid intake, being physically active, and weighing themselves each day.

Loneliness an important predictor

Only seven of the patients followed all four lifestyle recommendations. Nearly 48% got no exercise, and 19% rarely exercised. About 25% never and 17% rarely adhered to fluid restrictions, while 13% never and 22% rarely restricted salt intake. About 54% of patients weighed themselves less than once a week, and 17% did it once a week.

Salt and fluid restrictions help keep fluid retention under control, daily weighing alerts to worsening fluid retention, and exercise improves energy levels and quality of life, explained the authors of the study.

Failure to follow lifestyle recommendations or regularly take medications contributes to worsening heart failure symptoms and an increased risk of hospitalisation.

"Loneliness is the most important predictor of whether patients adopt the advice or not," study senior author Beata Jankowska-Polaska, from Wroclaw Medical University, said in a news release from the European Society of Cardiology.

"Patients who are alone do worse in all areas. Family members have a central role in helping patients comply, particularly older patients, by providing emotional support, practical assistance, and advice," she noted.

Instructions and reminders

"We also found that women were less compliant than men, and patients over 65 had poorer scores than younger patients," she added.

Loneliness, a higher number of other health problems, and heart failure that caused more physical limitations were independent predictors of not following the recommendations, the researchers said.

Doctors and nurses need to encourage better self-care in their patients with heart failure, according to Jankowska-Polaska.

"Patients need clear written instructions on how to exercise for example, while text messages or phone calls can be used as reminders. It's important to check that patients understand the advice, tailor the recommendations, and assess adherence at every visit," she said.

The research was presented at Heart Failure 2019, a meeting of the European Society of Cardiology, in Athens. Studies presented at scientific meetings should be considered preliminary until published in a peer-reviewed journal.

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