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  1. Article ; Online: Remote consultations: review of guiding themes for equitable and effective delivery.

    Khanji, Mohammed Y / Gallagher, Angela M / Rehill, Nirandeep / Archbold, R Andrew

    Current problems in cardiology

    2023  Volume 48, Issue 8, Page(s) 101736

    Abstract: The global coronavirus disease (COVID) -19 pandemic has led to a rapid transformation in the ways in which outpatient care is delivered. The need to minimise the risk of viral infection and transmission through social distancing resulted in the ... ...

    Abstract The global coronavirus disease (COVID) -19 pandemic has led to a rapid transformation in the ways in which outpatient care is delivered. The need to minimise the risk of viral infection and transmission through social distancing resulted in the widespread adoption of remote consultations, traditional face-to-face appointments ceasing almost overnight in many specialties. The transition to remote consultations had taken place far faster than anticipated and under crisis conditions. As we work towards the "new normal", remote consultations have become an integral part of outpatient provision in secondary care. Adapting to this change in clinical practice requires a judicious approach to ongoing service development to ensure safe, effective, and equitable care for all patients. Medical societies have provided some initial guidance around effective delivery. In this article we discuss the potential benefits, limitations, types of remote consultations, and factors that require consideration when deciding on patient suitability for remote consultation in a hospital setting. We use cardiology as a specialty exemplar, although many of the principles will be equally applicable to other medical specialties.
    MeSH term(s) Humans ; Remote Consultation/methods ; COVID-19/epidemiology ; Ambulatory Care ; Pandemics ; Hospitals
    Language English
    Publishing date 2023-04-17
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 441230-8
    ISSN 1535-6280 ; 0146-2806
    ISSN (online) 1535-6280
    ISSN 0146-2806
    DOI 10.1016/j.cpcardiol.2023.101736
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Se 505: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Sleep Disordered Breathing and Heart Failure: What Does the Future Hold?

    Cowie, Martin R / Gallagher, Angela M

    JACC. Heart failure

    2017  Volume 5, Issue 10, Page(s) 715–723

    Abstract: Most patients with heart failure (HF) have sleep-disordered breathing (SDB), with central (rather than obstructive) sleep apnea becoming the predominant form in patients with more severe disease. Cyclical apnea and hypopneas are associated with sleep ... ...

    Abstract Most patients with heart failure (HF) have sleep-disordered breathing (SDB), with central (rather than obstructive) sleep apnea becoming the predominant form in patients with more severe disease. Cyclical apnea and hypopneas are associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. These patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and can partially normalize the sleep and respiratory physiology. However, recent randomized trials of cardiovascular outcomes in central sleep apnea in chronic HF with reduced ejection fraction have had neutral findings or suggested the possibility of harm, likely from an increased rate of sudden death. Further randomized outcome studies are required to determine whether mask-based treatment is appropriate for patients with chronic HF with reduced ejection fraction and obstructive sleep apnea, for patients with heart failure with preserved ejection fraction, and for patients with decompensated heart failure. New therapies for sleep apnea (e.g., implantable phrenic nerve stimulators) also require robust assessment. No longer can the surrogate endpoints of improvement in respiratory and sleep metrics be taken as adequate therapeutic outcome measures in patients with HF and sleep apnea.
    MeSH term(s) Chronic Disease ; Death, Sudden, Cardiac/epidemiology ; Electric Stimulation Therapy ; Heart Failure/complications ; Heart Failure/physiopathology ; Hemodynamics ; Humans ; Hypoxia/complications ; Hypoxia/physiopathology ; Phrenic Nerve ; Positive-Pressure Respiration/methods ; Prognosis ; Severity of Illness Index ; Sleep ; Sleep Apnea Syndromes/complications ; Sleep Apnea Syndromes/physiopathology ; Sleep Apnea Syndromes/therapy ; Sleep Apnea, Central/complications ; Sleep Apnea, Central/physiopathology ; Sleep Apnea, Central/therapy ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/physiopathology ; Sleep Apnea, Obstructive/therapy ; Stroke Volume ; Sympathetic Nervous System/physiopathology ; Treatment Outcome
    Language English
    Publishing date 2017-09-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2705621-1
    ISSN 2213-1787 ; 2213-1779
    ISSN (online) 2213-1787
    ISSN 2213-1779
    DOI 10.1016/j.jchf.2017.06.016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Treating central sleep apnoea in heart failure: is pull better than push?

    Cowie, Martin R / Gallagher, Angela M / Simonds, Anita K

    European journal of heart failure

    2018  Volume 20, Issue 12, Page(s) 1755–1759

    MeSH term(s) Heart Failure ; Humans ; Phrenic Nerve ; Polysomnography ; Sleep Apnea, Central ; Sleep Apnea, Obstructive
    Language English
    Publishing date 2018-10-23
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 1483672-5
    ISSN 1879-0844 ; 1388-9842
    ISSN (online) 1879-0844
    ISSN 1388-9842
    DOI 10.1002/ejhf.1337
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5299: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  4. Article ; Online: Assessing health-related quality of life in heart failure patients attending an outpatient clinic: a pragmatic approach.

    Gallagher, Angela M / Lucas, Rebecca / Cowie, Martin R

    ESC heart failure

    2018  Volume 6, Issue 1, Page(s) 3–9

    Abstract: Aims: Improving quality of life (QoL) in heart failure patients is a key management objective. Validated health-related QoL (HR-QoL) measurement tools have been incorporated into clinical trials but not routinely into daily practice. The aims of this ... ...

    Abstract Aims: Improving quality of life (QoL) in heart failure patients is a key management objective. Validated health-related QoL (HR-QoL) measurement tools have been incorporated into clinical trials but not routinely into daily practice. The aims of this study were to investigate the acceptability and feasibility of implementing validated HR-QoL instruments into heart failure clinics and to examine the impact of patient characteristics on HR-QoL.
    Methods and results: One hundred and sixty-three patients attending heart failure clinics at a UK tertiary centre were invited to complete three HR-QoL assessments: the Minnesota Living with Heart Failure Questionnaire (MLHFQ); the EuroQoL 5D-3L (EQ-5D-3L); and the Kansas City Cardiomyopathy Questionnaire (KCCQ) in that order. Data on patient demographics, co-morbidities, New York Heart Association (NYHA) class, plasma B-type natriuretic peptide (BNP), renal function, and left ventricular ejection fraction were recorded. 94% of patients attending clinic were willing to participate. The EQ-5D-3L had all questions answered by 92% of patients, compared with 86% and 51% for the MLHFQ and KCCQ, respectively. HR-QoL significantly correlated with NYHA class using each tool (MLHFQ, r = 0.59; KCCQ, r = -0.61; EQ-5D-3L, r = -0.44, all P < 0.01). However, within each NYHA class, there was a widespread of HR-QoL scores. There was no association between patient demographics, left ventricular ejection fraction, plasma B-type natriuretic peptide, or renal function with HR-QoL using any tool.
    Conclusions: Health-related QoL assessment by validated questionnaire was acceptable to patients and feasible to perform in routine practice. Although NYHA class correlated significantly with HR-QoL scores, there was high variability in HR-QoL within each NYHA class, highlighting its limitation as the sole assessment of HR-QoL. Clinicians should encourage the assessment of HR-QoL to facilitate patient-centred care and make more specific use of HR-QoL measurement tools.
    MeSH term(s) Aged ; Ambulatory Care Facilities ; Feasibility Studies ; Female ; Follow-Up Studies ; Heart Failure/physiopathology ; Heart Failure/psychology ; Humans ; Male ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; Ventricular Function, Left/physiology
    Language English
    Publishing date 2018-10-11
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2814355-3
    ISSN 2055-5822 ; 2055-5822
    ISSN (online) 2055-5822
    ISSN 2055-5822
    DOI 10.1002/ehf2.12363
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The search for cardiovascular benefit from treating obstructive sleep apnoea with CPAP therapy.

    Cowie, Martin R / Gallagher, Angela M / Simonds, Anita K

    European heart journal

    2017  Volume 39, Issue 24, Page(s) 2298–2300

    MeSH term(s) Cardiovascular Diseases ; Cardiovascular System ; Continuous Positive Airway Pressure ; Humans ; Sleep Apnea, Obstructive
    Language English
    Publishing date 2017-11-28
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehx678
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    In stock of ZB MED Cologne/Königswinter

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