AHA statement addresses how social determinants affect outcomes, impact caregivers

Treatment for heart failure should take into consideration a patient's social determinants of health, including their overall living environment and socio-economic status, according to new guidance published in the journal Circulation.  

Heart failure, which affects 6.5 million Americans, is a slow, progressive disease in which the heart does not pump blood effectively. Although there is no cure, people with heart failure can live full lives with the help of medication, lifestyle changes, and social support. Caregivers are needed as the disease progresses and when an individual is no longer able to manage the activities of daily living or complex medical regimens.

The scientific statement provides an overview of scientific research that demonstrates how the county where a patient lives, personal and social factors, such as insurance status, disability status, race, ethnicity, and income inequality, may impact patients from receiving care for their heart failure.

To help overcome non-medical barriers to effective care for people with heart failure, the statement suggests a best practice scenario where an interprofessional health care team works together to support the patients, their families and caregivers. This support should address the numerous life challenges that can impact health outcomes, such as the patient's living situation, caregiver availability, ability to pay for medications and how well a patient and their caregiver understand medical information.

The statement urges health care providers to routinely discuss a heart failure patient's overall living situation to identify challenges that affect their medical care. Whenever possible, healthcare providers should:

• Assist patients seeking insurance coverage, financial assistance, affordable housing or employment
• Present health information in formats tailored to meet each individual's language, level of education and health literacy
• Support nurse-led collaborative clinics that assist patients in becoming better stewards of their own health
• Use medication access programs to help provide drugs out of patients' financial reach
• Partner with local food banks to help provide groceries to food-insecure patients