By Dr. Colleen Morley, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM
February's designation as Heart Month traces back to a proclamation by President Lyndon B. Johnson in 1964. President Johnson, himself a heart attack survivor, officially declared February as American Heart Month. This initiative was a response to the rising incidence of heart disease in the United States, which was emerging as a leading cause of death. The declaration aimed to encourage Americans to adopt heart-healthy lifestyles to reduce their risk of heart diseases. Since then, February has been annually observed as a month dedicated to raising awareness about heart health, promoting healthy habits, and supporting
As to the impact of heart disease, the statistics speak for themselves, loud and clear:
Cardiovascular disease (CVD) remains the leading cause of death in the United States, accounting for 928,741 deaths. The mortality rate is significantly influenced by coronary heart disease (CHD), which was the leading cause of 41.2% of CVD-related deaths, followed by stroke (17.3%), other forms of cardiovascular disease (16.8%), high blood pressure (12.9%), heart failure (9.2%), and diseases of the arteries (2.6%) with approximately 695,000 people in the United States dying from heart disease in 2021, representing 1 in every 5 deaths. This statistic underscores the significant health impact of heart disease on the population (Centers for Disease Control and Prevention, 2023).
Approximately 11.2% of American adults suffer from heart disease. The prevalence increases significantly with age, particularly among those aged 75 and above, where the rate is 37.3%. Additionally, heart disease affects males more than females, with a prevalence of 12.6% in males compared to 10.1% in females (Centers for Disease Control and Prevention, 2023). The economic burden of cardiovascular disease is substantial. Between 2018 and 2019, the direct and indirect costs of total cardiovascular diseases in the U.S. amounted to approximately $407.3 billion. This figure includes $251.4 billion in direct healthcare costs and $155.9 billion in lost productivity and mortality (Centers for Disease Control and Prevention, 2023). (Centers for Disease Control and Prevention, 2023).
These statistics highlight the critical need for ongoing efforts in education, prevention, and research to combat heart disease and improve cardiovascular health nationwide.
Heart disease remains one of the leading causes of death worldwide, but it's also a condition that can often be prevented or managed effectively with the right interventions. Case managers play a vital role in this context, helping patients navigate through the complexities of healthcare systems and lifestyle choices to significantly reduce their risk. Here's a look at how case managers work with patients to prevent heart disease using the case management process:
Initial Assessment and Risk Identification
The prevention of heart disease begins with a comprehensive evaluation of the patient's medical history, current health status, and risk factors such as high blood pressure, obesity, and family history. Case managers collaborate with healthcare providers to assemble this information, which serves as the foundation for tailored prevention strategies.
Creating a Personalized Care Plan
Based on the initial assessment, a personalized care plan is developed. It encompasses medical treatments, dietary adjustments, exercise regimens, and other interventions that can effectively mitigate the identified risk factors. Importantly, this plan is not static; it’s continuously reviewed and adjusted as needed, based on regular health screenings and consultations.
Patient Education and Empowerment
One of the most critical roles of a case manager in preventing heart disease is patient education. This includes not just conveying medical advice, but also teaching patients how to interpret their medical reports, understand their medication, and recognize early signs of potential heart issues. When patients are well-informed, they can take a proactive role in managing their health.
Lifestyle Coaching
Unhealthy lifestyle choices, like poor diet and lack of exercise, are significant contributors to heart disease. Case managers often collaborate with nutritionists, physiotherapists, and other specialists to guide patients toward healthier habits. They may help set achievable goals, such as walking a certain number of steps per day or incorporating more fruits and vegetables into their diet.
Coordinating Multidisciplinary Care
Preventing heart disease usually involves multiple healthcare disciplines—from cardiologists to dietitians, and from pharmacists to mental health professionals. Case managers coordinate the efforts of this diverse team, ensuring that everyone is on the same page and that the care provided is not just comprehensive but also cohesive.
Medication Management
Medications, such as statins or antihypertensives, may be prescribed as part of a heart disease prevention strategy. Case managers help manage these medications, ensuring that patients understand the importance of adherence, potential side effects, and any drug interactions.
Monitoring and Adjusting the Care Plan
The journey to prevent heart disease is an ongoing process. Case managers continuously monitor the effectiveness of the intervention strategies by looking at key metrics like cholesterol levels, blood pressure, and patient compliance to lifestyle changes. This data helps them tweak the care plan as needed.
Emotional and Psychological Support
Lastly, case managers provide crucial emotional support, encouraging patients through their prevention journey. The psychological aspect of healthcare is often underemphasized but is incredibly important, especially in long-term prevention strategies.
Case managers serve as essential partners in the fight against heart disease. Through assessment, planning, education, and continuous support, they help patients mitigate risks and make healthier choices. Their multifaceted role is instrumental in ensuring that patients not only live longer but also enjoy a better quality of life
Centers for Disease Control and Prevention (2023). Heart disease facts. https://www.cdc.gov/heartdisease/facts.htm#:~:text=About%20695%2C000%20people%20in%20the,Coronary%20Artery%20Disease
CMSA's ICM program provides multiple strategies to engage clients, stratify risk, and develop care plans to mitigate risk and help clients achieve improved health and well-being. Join us to learn these concepts through engaged learning, self-study and interactive sessions with your peers. Through CMSA’s new ICM Training, program elements and training activities have been updated to reflect the new ICM manual. Register Now for the virtual Spring training, April 16 - 18, 2024. Earn 28.5 RN, SW, and CCM credits. Register here: https://cmsapmg.wpenginepowered.com/integrated-case-management/
Bio: Dr. Colleen Morley DNP RN CCM CMAC CMCN ACM-RN FCM is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current President of the Case Management Society of America National Board of Directors. She has held positions in acute care as Director of Case Management at several acute care facilities and managed care entities in Illinois, overseeing Utilization Review, Case Management and Social Services for over 14 years; piloting quality improvement initiatives focused on readmission reduction, care coordination through better communication and population health management. Her current passion is in the area of improving health literacy. She is the recipient of the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020) for her work in this area. Dr. Morley also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her 1st book, “A Practical Guide to Acute Care Case Management”, published by Blue Bayou Press was released in February, 2022. Dr. Morley has over 20 years of nursing experience. Her clinical specialties include Med/Surg, Oncology and Pediatric Nursing. She received her ADN at South Suburban College in South Holland, IL; BSN at Jacksonville University in Jacksonville, FL, MSN from Norwich University in Northfield, VT and her DNP at Chamberlain College of Nursing.