Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Case Report

Volume 8, Number 6, December 2017, pages 339-343

A Case of Multifaceted Assessment in an Elderly Patient With Acute Decompensated Heart Failure

**Table 1.** A Multifaceted Assessment Using Eight Different Evaluations (A-H)
Score, points	1 (failure)	2 (poor)	3 (fair)	4 (good)	5 (excellent)
A. Prediction of survival in heart failure (HF) using the Seattle Heart Failure Model (SHFM)
Mean life expectancy, years	< 2	≥ 2 and < 3	≥ 3 and < 4	≥ 4 and < 5	≥ 5
B. Dementia
Score, points	1	2	3	4	5
Revised Hasegawa’s dementia scale (HDS-R), points	≤ 6	7 - 12	13 - 18	19 - 24	25 - 30
C. Nutrition
Score, points	1	2	3	4	5
Mini-nutritional assessment (MNA), points	≤ 10	> 10 and < 17	≥ 17 and < 21	≥ 21 and < 24	24 - 30
D. Medication adherence
Score, points	1	2	3	4	5
Adherence, points	< 30	30 - 39	40 - 49	50 - 59	60 - 70
E. Biomarker
Score, points	1	2	3	4	5
Brain natriuretic peptide (BNP), pg/mL	> 500	200 - 500	100 - 199	40 - 99	< 40
F. Sociality
Score, points	1	2	3	4	5
Home care score (HCS), points	≤ 3	4 - 6	7 - 8	9 - 10	> 10
G. Performance
Score, points	1	2	3	4	5
Modified frailty index derived from the Canadian Study of Health and Aging (CSHA), frailty impression	Terminally - very severely frail	Severely - moderately frail	Moderately frail	Mildly frail - vulnerable	Managing well - well - very fit
H. Comorbidity
Score, points	1	2	3	4	5
Charlson comorbidity index, points	≥ 6	5	3 - 4	1 - 2	0

Table 1. A Multifaceted Assessment Using Eight Different Evaluations (A-H)

Score, points

1 (failure)

2 (poor)

3 (fair)

4 (good)

5 (excellent)

A. Prediction of survival in heart failure (HF) using the Seattle Heart Failure Model (SHFM)

Mean life expectancy, years

< 2

≥ 2 and < 3

≥ 3 and < 4

≥ 4 and < 5

≥ 5

B. Dementia

Score, points

Revised Hasegawa’s dementia scale (HDS-R), points

≤ 6

7 - 12

13 - 18

19 - 24

25 - 30

C. Nutrition

Score, points

Mini-nutritional assessment (MNA), points

≤ 10

> 10 and < 17

≥ 17 and < 21

≥ 21 and < 24

24 - 30

D. Medication adherence

Score, points

Adherence, points

< 30

30 - 39

40 - 49

50 - 59

60 - 70

E. Biomarker

Score, points

Brain natriuretic peptide (BNP), pg/mL

> 500

200 - 500

100 - 199

40 - 99

< 40

F. Sociality

Score, points

Home care score (HCS), points

≤ 3

4 - 6

7 - 8

9 - 10

> 10

G. Performance

Score, points

Modified frailty index derived from the Canadian Study of Health and Aging (CSHA), frailty impression

Terminally - very severely frail

Severely - moderately frail

Moderately frail

Mildly frail - vulnerable

Managing well - well - very fit

H. Comorbidity

Score, points

Charlson comorbidity index, points

≥ 6

3 - 4

1 - 2

**Table 2.** Medication Adherence Scale
	Points
1 point: not applicable; 2 point: not very true; 3 point: neither agree nor disagree; 4 point: slightly true; 5 point: applies.
A. Coordination with medical staff regarding medication
1) Regarding medicine, I can ask medical staff such as medical doctors without hesitation.	1 - 5
2) Regarding medicine, I can share my previous treatment course with medical staff such as medical doctors.	1 - 5
3) Regarding medicine, I can share my thoughts and goals with medical staff such as medical doctors.	1 - 5
B. Aggressiveness in acquiring and using information about medication
4) I ask if there is something I do not know about my medication.	1 - 5
5) I report side effects of medicines, allergic symptoms, and unusual symptoms.	1 - 5
6) I know about my medicines and why they are needed.	1 - 5
7) I use approaches to continue taking my medicine (ingenuity in daily life, etc.)	1 - 5
8) I am looking for and using information necessary for my medicines.	1 - 5
C. Conviction regarding medication and degree of cooperation
9) I am convinced about the necessity of my medicines.	1 - 5
10) The use of medicines is part of my life, like eating meals and brushing my teeth.	1 - 5
11) My family members and other people offer no resistance to helping me, such as by making phone calls regarding my medications.	1 - 5
D. Compliance with medication
12) Medication has been used for the indicated number of times or tablets over the last three weeks.	1 - 5
13) Medication has been used for the indicated time over the last three weeks.	1 - 5
14) I did not stop taking my medicines at my own discretion.	1 - 5
Total points	14 - 70

Table 2. Medication Adherence Scale

Points

1 point: not applicable; 2 point: not very true; 3 point: neither agree nor disagree; 4 point: slightly true; 5 point: applies.

A. Coordination with medical staff regarding medication

1) Regarding medicine, I can ask medical staff such as medical doctors without hesitation.

1 - 5

2) Regarding medicine, I can share my previous treatment course with medical staff such as medical doctors.

1 - 5

3) Regarding medicine, I can share my thoughts and goals with medical staff such as medical doctors.

1 - 5

B. Aggressiveness in acquiring and using information about medication

4) I ask if there is something I do not know about my medication.

1 - 5

5) I report side effects of medicines, allergic symptoms, and unusual symptoms.

1 - 5

6) I know about my medicines and why they are needed.

1 - 5

7) I use approaches to continue taking my medicine (ingenuity in daily life, etc.)

1 - 5

8) I am looking for and using information necessary for my medicines.

1 - 5

C. Conviction regarding medication and degree of cooperation

9) I am convinced about the necessity of my medicines.

1 - 5

10) The use of medicines is part of my life, like eating meals and brushing my teeth.

1 - 5

11) My family members and other people offer no resistance to helping me, such as by making phone calls regarding my medications.

1 - 5

D. Compliance with medication

12) Medication has been used for the indicated number of times or tablets over the last three weeks.

1 - 5

13) Medication has been used for the indicated time over the last three weeks.

1 - 5

14) I did not stop taking my medicines at my own discretion.

1 - 5

Total points

14 - 70