Heart failure is a complex chronic medical condition that has a significant impact on life expectancy and quality of life. Complex medical therapy such as multiple medications can lead to poor adherence, leading to poorer patient outcomes. Overcoming this is a strength of the Bristol Community Health (BCH) community heart failure service, where patients benefit from education around non-pharmacological management.

Medical management of long-term conditions such as heart failure is not without its problems. Many tablets can have detrimental effects on renal function, hence the careful up-titration of medication along with diligent monitoring of renal function.

Acute kidney injury is a risk to patients taking the traditional combination of heart failure medication, particularly in circumstances that place the patient at risk of dehydration. Early recognition and intervention can go a long way to protecting individuals’ renal function. The heart failure team at BCH hopes to minimise this risk by educating patients about the ‘sick day rule’. Cards and information sheets provide useful references for patients.