One of the most common symptoms of heart failure, diagnosed in around 550,000 people in the UK but with many more thought to be affected, is fluid retention, arising from the heart’s inability to pump blood around the body effectively, and which can lead to people feeling breathless.
As the condition progresses, oral treatments to combat fluid retention (diuretics) can stop working and many patients have traditionally needed to go into hospital so that they can be treated with intravenous (IV) therapy. The average stay for these patients is approximately 13 days and this treatment alone accounts for two per cent of all NHS bed days. A large percentage of heart failure patients in the UK will need IV diuretic treatment at some point in their illness.
The two year pilot project looked at 96 patients in 10 NHS organisations around the UK and aimed to investigate if IV diuretics could be delivered safely outside of hospital by specially trained heart failure nurses either in the person’s home or in a community setting close by.
The results showed overwhelmingly that treatment outside hospital was safe and viable and the response was positive with 100 per cent satisfaction from the people receiving the treatment and 93 per cent satisfaction from carers. The project showed that, with specialised training, nurses could safely and effectively provide intravenous diuretics for patients, largely in the comfort of their own homes.
This meant it became unnecessary for many patients to be admitted to hospital to receive a course of treatment, often for many days at a time. This pilot alone enabled 79% of participants to avoid hospital admissions, and saved 1040 in-patient bed days at a saving of £162,740 for the NHS Trusts and health boards involved.
The project marks a huge step forward towards improving the quality of life for people living with heart failure, as well as their families.
The scheme was set up to help people with advanced heart failure remain at home rather than in hospital and is now being considered and implemented by a number of other NHS organisations, but more needs to be done so that it can become standard practice across the country. People should be able to access this kind of treatment in their own homes, regardless of where they live and provides people with a choice to remain at home at the end of their lives.
Catherine Kelly, Director of Prevention, Survival and Support at the British Heart Foundation, said: “IV diuretics is a ground-breaking initiative has the potential to help hundreds of thousands of patients remain close to home rather than spending a cumulative two million bed days in hospital each year. This simple but effective change in service delivery shows that true innovation which transforms patients’ lives doesn’t always come in the form of a new drug treatment. This innovation shows how something as simple as changing the location of treatment can improve clinical outcomes improve people’s everyday lives by supporting them to remain at home and avoiding what is often a distressing unplanned hospital admission.”