Analysis of the activity of the telephone nursing consultation on demand for patients with heart failure.

OBJECTIVE: Analyzing the most frequent reasons for telephone demand in the heart failure nurse's consultation and to evaluate the response resolution capacity after the call. METHOD: Descriptive, retrospective study of all telephone calls recorded between June 2020 and April 2021 in a specific nursing consultation for heart failure care. The main sociodemographic and clinical variables, reason for calling and action carried out by the nurse were extracted from the electronic medical records. For its subsequent descriptive análisis. RESULTS: 643 calls were analyzed, 354 (55.1%) were made by the patients. The most frequent reason for calling was to consult symptoms 45.8% (n = 162). 71.6% (n = 116) of the consultations were resolved by adjusting the pharmacological treatment by telephone, 24.7% (n = 40) required a face-to-face visit in the nurse's consultation, 22 (13.6%) needed emergency care. 5 due to worsening heart failure. The patients who consulted for symptoms had a worse functional class (p = 0.007) and had been referred from hospitalization (p = 0.023). CONCLUSIONS: The telephone consultation was shown to be useful for patients with heart failure, being mainly demanded by users who present symptoms of worsening of their disease.

The Novel Variant NP_00454563.2 (p.Glu259Glyfs*77) in Gene PKP2 Associated with Arrhythmogenic Cardiomyopathy in 8 Families from Malaga, Spain.

INTRODUCTION AND OBJECTIVES: Arrhythmogenic cardiomyopathy (ACM) is a hereditary heart disease defined by the progressive replacement of the ventricular myocardium with fibroadipose tissue, which can act as a substrate for arrhythmias, sudden death, or even give rise to heart failure (HF). Sudden death is frequently the first manifestation of the disease, particularly among young patients. The aim of this study is to describe a new pathogenic variant in the PKP2 gene. METHODS: A descriptive observational study that included eight initially non-interrelated families with a diagnosis of ACM undergoing follow-up at our HF and Familial Cardiomyopathies Unit, who were carriers of the NM_004572.3:c.775_776insG; p.(Glu259Glyfs*77) variant in the PKP2 gene. The genetic testing employed next-generation sequencing for the index cases and the Sanger method for the targeted study with family members. We compiled personal and family histories, demographic and clinical characteristics, data from the additional tests at the time of diagnosis, and arrhythmic events at diagnosis and during follow-up. RESULTS: We included 47 subjects, of whom 8 were index cases (17%). Among the evaluated family members, 16 (34%) were carriers of the genetic variant, 3 of whom also had a diagnosis of ACM. The majority were women (26 patients; 55.3%), with a mean age on diagnosis of 48.9 ± 18.6 years and a median follow-up of 39 [24-59] months. Worthy of note are the high incidences of arrhythmic events as the form of presentation and in follow-up (21.5% and 20.9%, respectively), and the onset of HF in 25% of the sample. The most frequent ventricular involvements were right (four patients, 16.7%) and biventricular (four patients, 16.7%); we found no statistical differences in any of the variables analysed. CONCLUSIONS: This variant is a pathogenic variant of gene PKP2 that has not previously been described and is not present in the control groups associated with ACM. It has incomplete penetrance, a highly variable phenotypic expressivity, and was identified in eight families of our geographical area in Malaga (Andalusia, Spain), suggesting a founder effect in this area and describe the clinical and risk characteristics.

Análisis de la actividad de la consulta de enfermería telefónica a demanda para pacientes con insuficiencia cardíaca / Analysis of the activity of the telephone nursing consultation on demand for patients with heart failure

Objetivo: Analizar los motivos más frecuentes de demanda telefónica en la consulta de la enfermera de insuficiencia cardiaca y evaluar la capacidad de resolución de respuesta tras la llamada. Método: Estudio descriptivo, retrospectivo, de todas las llamadas telefónicas registradas entre junio de 2020 y abril de 2021 en una consulta específica de enfermería para la atención a la insuficiencia cardiaca. De las historias clínicas electrónicas se extrajeron las principales variables sociodemográficas y clínicas, el motivo de llamada y la acción realizada por la enfermera, para su posterior análisis descriptivo. Resultados: Se analizaron 643 llamadas, 354 (55,1%) de las cuales fueron realizadas por los pacientes. El motivo de llamada más frecuente fue para consultar síntomas: 45,8% (n=162). El 71,6% (n=116) de las consultas se solucionaron ajustando el tratamiento farmacológico por teléfono, el 24,7% (n=40) precisaron una visita presencial en la consulta de la enfermera, necesitaron atención en urgencias 22 (13,6%) pacientes: 5 por empeoramiento de la insuficiencia cardiaca. Los pacientes que consultaron por síntomas presentaban peor clase funcional (p=0,007) y habían sido derivados desde hospitalización (p=0,023). Conclusiones: La consulta telefónica se mostró útil para pacientes con insuficiencia cardiaca, siendo principalmente demandada por usuarios que presentan síntomas de empeoramiento de su enfermedad.(AU)

Objective: Analyzing the most frequent reasons for telephone demand in the heart failure nurse's consultation and to evaluate the response resolution capacity after the call. Method: Descriptive, retrospective study of all telephone calls recorded between June 2020 and April 2021 in a specific nursing consultation for heart failure care. The main sociodemographic and clinical variables, reason for calling and action carried out by the nurse were extracted from the electronic medical records, for its subsequent descriptive analysis. Results: A total of 643 calls were analyzed, 354 (55.1%) were made by the patients. The most frequent reason for calling was to consult symptoms: 45.8% (n=162). 71.6% (n=116) of the consultations were resolved by adjusting the pharmacological treatment by telephone, 24.7% (n=40) required a face-to-face visit in the nurse's consultation, 22 (13.6%) needed emergency care: 5 due to worsening heart failure. The patients who consulted for symptoms had a worse functional class (P=.007) and had been referred from hospitalization (P=.023). Conclusions: The telephone consultation was shown to be useful for patients with heart failure, being mainly demanded by users who present symptoms of worsening of their disease.(AU)

Plan de cuidados relacionado con el proceso asistencial integrado atención a las perso-nas fumadoras / Care plan related to the integrated healthcare process for smokers

El tabaco es una de las drogas legales más consumidas en el mundo y un importante factor de riesgo de morbi-mortalidad asociado a diferentes enfermedades. Se describe el caso de un paciente que acude a la consulta de enfermería de su centro de salud, detectado como consu-midor de tabaco y captado para realizar un plan de cuidados mediante el Proceso Asistencial Integrado de Atención a Personas Fumadoras. Los principales diagnósticos de enfermería se relacionaron con una tendencia a adoptar conductas de riesgo para la salud, conflicto de deci-siones (dejar de fumar) y disposición para mejorar los conocimientos. Se desarrollaron medi-das como la terapia de grupo, además de la reducción del consumo de nicotina diaria hasta su completa eliminación. Este proceso constituye una herramienta de ayuda para seguir traba-jando en una atención sanitaria centrada en el paciente.

Tobacco is one of the most consumed legal drugs in the world and an important risk factor for morbidity and mortality. The case of a patient who goes to the nursing consultation of a Health Center is described. He was detected as a tobacco consumer and captured to carry out a care plan for the Integrated Healthcare Process for Smokers. The main nursing diagnoses were related to a tendency to adopt risky behaviors for health, conflict of decisions (quit smo-king) and updating to improve knowledge. It was developed group therapy, and reduction of daily nicotine consumption until its complete elimination. This process is a helpful tool to keep working in a patient-centered medical care.Tobacco is one of the most consumed legal drugs in the world and an important risk factor for morbidity and mortality. The case of a patient who goes to the nursing consultation of a Health Center is described. He was detected as a tobacco consumer and captured to carry out a care plan for the Integrated Healthcare Process for Smokers. The main nursing diagnoses were related to a tendency to adopt risky behaviors for health, conflict of decisions (quit smo-king) and updating to improve knowledge. It was developed group therapy, and reduction of daily nicotine consumption until its complete elimination. This process is a helpful tool to keep working in a patient-centered medical care.