Nonpharmacologic interventions in the treatment of heart failure

Chronic heart failure represents a significant challenge to caregivers because these patients are fragile, care is complex, and the numbers of patients are increasing dramatically. The anticipated illness trajectory is also rapidly changing due to the advent of pharmacologic interventions that offer greatly improved outcomes and quality of life for these patients. Despite such advances, mortality and morbidity remain high. Therefore, an important goal is to develop and evaluate nonpharmacologic interventions as adjuvant therapy to the traditional pharmacologic approach. Although relatively few studies have examined nonpharmacologic treatment strategies, it appears that many patients with heart failure may benefit significantly from participation in long-term aerobic exercise conditioning programs. Psychological and biobehavioral interventions also have the potential to substantially enhance treatment outcomes and quality of life for patients with chronic heart failure. This article reviews the available literature about nonpharmacologic strategies in the treatment of heart failure along with specific recommendations for practice.