Outpatient-based acute HF care calls for development of clinical psychology service for whole-person care provision

Abstract

Acute heart failure (AHF) is associated with 9.3% mortality. Depression and hopelessness are prevalent. We conducted an online survey using Survey Monkey, via the UK Heart Failure (HF) Investigators Research Network of 309 cardiologists, in 2021, to determine: what proportion of UK centres offer outpatient-based management (OPM) for AHF including the use of parenteral diuretics; and what proportion of HF services have clinical psychology support. There were 51 services that responded, and an estimated 25,135 patients with AHF receive inpatient care per year (median 600 per site). There are 2,631 patients (median 50 per site) treated per year with OPM (9.7% of the population of AHF patients). While 65% of centres provided access to OPM, only 20% have a clinical psychology service. In conclusion, nearly 10% of patients with AHF receive outpatient-based intravenous diuretic therapy. Only 20% of hospitals have a clinical psychology service for patients who suffer from HF.

Keywords: clinical psychology; congestive cardiac failure; diuretics; outpatient services; subcutaneous.

Figure 1.. Where is outpatient parenteral diuretic service based?