Getting to the “Heart” of Health Care Costs–Heart Failure and Medicare Costs

Dr. Barbara Riegel
Professor and Edith Clemmer Steinbright Chair of Gerontology
Director, Biobehavioral Research Center
Chair, Graduate Group in Nursing
University of Pennsylvania, School of Nursing. Philadelphia, PA

Background:

Dr Riegel has been studying heart failure self-care for the past 17 years. She is also co-editor of the Journal of Cardiovascular Nursing. The self-report instrument she developed to measure heart failure self-care has been translated into more than 20 languages and is used globally.

She is also the Director of the Biobehavioral Research Center, leading a group of interdisciplinary scholars within the school involved in scientific inquiry and professional mentoring in advancing knowledge about the interaction of biological and behavioral factors in the promotion of health. Dr. Riegel is an established nurse scientist studying adults with cardiovascular disease. Her primary research interest is self-care of older adults with heart failure. This interest grew out of her early years as a Clinical Nurse Researcher at Sharp HealthCare in San Diego, California, where she performed some of the seminal work in heart failure disease management.

Since moving across the country 10 years ago to join the faculty at the University of Pennsylvania her work on heart failure self-care has evolved to a focus on understanding the mechanisms for the poor self-care seen in both developed and developing populations worldwide. Cognition and sleep are the factors she is most actively exploring at this time.  Her research has influenced public policy and clinical practice widely.

Dr. Riegel has served as a Fulbright scholar in Australia and Italy. She is currently a visiting Professor at Linköping University in Sweden. She is the founding Editor and current co-Editor of the Journal of Cardiovascular Nursing (JCN), one of the top 10 journals in nursing worldwide.

She has received numerous honors for her contributions to the field including the Katherine A. Lembright Award from the American Heart Association, Council on Cardiovascular Nursing and the Barbara J. Lowery Doctoral Student Organization Faculty Award, the University of Pennsylvania.

She has consulted and lectured across the world on the issues faced by older adults with heart failure and written over 200 scholarly articles published in peer-reviewed, interdisciplinary and international journals, edited three books, and written numerous book chapters.

Dr. Riegel is a fellow in the American Heart Association and in the American Academy of Nursing.

Overview:

Dr. Riegel talks about heart failure, a condition that affects 1 in 5 older adults. Heart failure is the reason that Medicare is having so much trouble balancing their budget. 1 in 4 heart failure patients are readmitted to a hospital within 30 days and almost half are readmitted within 6 months. Dr. Riegel talks with us about what it’s like to live with heart failure and how taking care of yourself can decrease symptoms and improve the quality of your life.

3 Key Points:

1. Avoid getting heart failure if you don’t already have it—keep your blood pressure between top # and bottom #: 140/90, lose weight, stop smoking, stay physically active.
2. If you have heart failure, get engaged in self-care! Take your medicines regularly, eat a low salt diet, stay physically active.
3. Avoid hospitalization through routine monitoring for fluid retention (“body listening”).