Journal article
Factors associated with poor self-management documented in home health care narrative notes for patients with heart failure
Heart & lung, Vol.55, pp.148-154
09/2022
DOI: 10.1016/j.hrtlng.2022.05.004
PMCID: PMC11021173
PMID: 35597164
Abstract
•Patients with HF who have poor self-management can be identified from narrative notes using NLP.•Younger age, gender (male), smoking, and comorbid conditions are associated with poor self-management.•Knowing which patient factors are associated with poor self-management may assist HHC clinicians in developing individualized care plans.
Patients with heart failure (HF) who actively engage in their own self-management have better outcomes. Extracting data through natural language processing (NLP) holds great promise for identifying patients with or at risk of poor self-management.
To identify home health care (HHC) patients with HF who have poor self-management using NLP of narrative notes, and to examine patient factors associated with poor self-management.
An NLP algorithm was applied to extract poor self-management documentation using 353,718 HHC narrative notes of 9,710 patients with HF. Sociodemographic and structured clinical data were incorporated into multivariate logistic regression models to identify factors associated with poor self-management.
There were 758 (7.8%) patients in this sample identified as having notes with language describing poor HF self-management. Younger age (OR 0.982, 95% CI 0.976–0.987, p < .001), longer length of stay in HHC (OR 1.036, 95% CI 1.029– 1.043, p < .001), diagnosis of diabetes (OR 1.47, 95% CI 1.3–1.67, p < .001) and depression (OR 1.36, 95% CI 1.09–1.68, p < .01), impaired decision-making (OR 1.64, 95% CI 1.37–1.95, p < .001), smoking (OR 1.7, 95% CI 1.4–2.04, p < .001), and shortness of breath with exertion (OR 1.25, 95% CI 1.1–1.42, p < .01) were associated with poor self-management.
Patients with HF who have poor self-management can be identified from the narrative notes in HHC using novel NLP methods. Meaningful information about the self-management of patients with HF can support HHC clinicians in developing individualized care plans to improve self-management and clinical outcomes.
Details
- Title: Subtitle
- Factors associated with poor self-management documented in home health care narrative notes for patients with heart failure
- Creators
- Sena Chae - University of IowaJiyoun Song - Columbia UniversityMarietta Ojo - VNS HealthKathryn H. Bowles - VNS HealthMargaret V. McDonald - VNS HealthYolanda Barrón - VNS HealthMollie Hobensack - Columbia UniversityErin Kennedy - University of PennsylvaniaSridevi Sridharan - VNS HealthLauren Evans - VNS HealthMaxim Topaz - VNS Health
- Resource Type
- Journal article
- Publication Details
- Heart & lung, Vol.55, pp.148-154
- DOI
- 10.1016/j.hrtlng.2022.05.004
- PMID
- 35597164
- PMCID
- PMC11021173
- NLM abbreviation
- Heart Lung
- ISSN
- 0147-9563
- eISSN
- 1527-3288
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 09/2022
- Academic Unit
- Nursing
- Record Identifier
- 9984368090402771
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