Ending the consultation
Every consultation is different but the following questions may provide a useful framework
“Is there anything you’d like me to go over again or ask me?”
- Asking this question gives the patient permission to ask for some key information to be repeated
- The patient may not have any questions at this point, but suggest they make a note of any that occur in the future and pop back in to ask them.
General points
- Ask about OTC medicines – in particular oral NSAIDs, which are contraindicated
- Ask about herbal remedies in case of interactions with medicines for heart failure or other common co-morbidities (e.g. St John’s Wort, ginkgo, glucosamine and chondroitin, turmeric) or possible adverse effects on the heart (e.g. hawthorn, blue cohosh)
- Vaccination for influenza (annually), Covid boosters (in line with national guidance) and pneumococcal vaccine (once) are all recommended
- Fluid intake does not need to be restricted but where congestion is an issue, sensible fluid intake (2-2½ litres/day) is advised. In hot weather this amount may need to be increased
Signposting
Useful resources patients can be signposted to include:
- Pumping Marvellous: Patient’s guide to being told you have heart failure; Symptom checker; Guide to medicines for heart failure
- British Heart Foundation: Heart failure information; Your guide to heart failure; Heart failure personal record