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Background: Chronic heart failure (CHF) is one of the most mortal and disabling of cardiovascular disease (CVD) syndromes, and represents an international health problem. However, there is currently a lack of awareness and research surrounding the disease, which results in an insufficient understanding of both the nature of the illness as well as the managing of it. Objective: To describe and increase the awareness of specific barriers to care a CHF patient may experience - reporting their commonness, severity and expected consequences. Material and methods: Patients were recruited by research teams for the WHICH? II trial - recruitment beginning 1st of July 2013 and completed the 31st of January 2016. A baseline profile from all the eligible participants was collected by applying a combination of extensive self-report and review of patient records (also conducted by the same research team), and the following analysis and characterization of the study population we carried out was done using the statistical program SPSS. In addition, there was conducted a supplementary literary study. Results: Amongst the study cohort there was an obvious presence of barriers that could hinder the patient in effective managing of their health and disease. We identified and described five of these barriers: living remote from health care services, age in the upper quartile (83+), cognitive impairment and/or language barrier, living alone, NYHA class III or IV. Due to this observable and evident presence one can describe the barriers surveyed as common and with high frequency amongst CHF patients. All of the barriers had a high prevalence, and the least common barrier still was present in around ¼ of the study cohort. All of these barriers can also be viewed as possible roots for complications in the patients maintaining of good health and disease management. Looking at the existing knowledge regarding each individual barrier, it is obvious that these factors have a high potential risk of affecting the patient’s ability to manage their own health and condition. Conclusions: The barriers to health care described can despite their variations all be characterized as common hindrances for the typical CHF patient. Some of the individual barriers vary in severity and therefore also in their potential risks and likelihood.


Mary MacKillop Institute for Health Research

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Open Access Report

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Open Access


This report is a result of a survey of data collected by Professor Simon Stewart, of the Mary MacKillop Institute for Heath Research, and his research team for the Which Heart failure Intervention is most Cost-effective in reducing Hospital care (WHICH?) II trial.