22
Treatment
Table 11. Potential Barriers to Effective HF Self-Care and
Example Interventions
Potential
Barrier Example Screening Tools
Example Interventions
Medical Barriers
Cognitive
impairment
• Mini-Cog
• Mini-Mental State
Examination (MMSE)
• Montreal Cognitive
Assessment (MoCA)
• Home health aide
• Home meal deliveries
• Adult day care
• Geriatric psychiatry referral
• Memory care support groups
Depression • Hamilton Depression
Rating Scale (HAM-D)
• Beck Depression
Inventory-II (BDI-II)
• Patient Health
Questionnaire-9 (PHQ-9)
• Psychotherapy
• Selective serotonin reuptake
inhibitors
• Nurse-led support
Substance use
disorders
• Tobacco, Alcohol,
Prescription medication,
and other Substance use
(TAPS)
• Referral to social work services
and community support partners
• Referral for addiction psychiatry
consultation
Frailty • Fried frailty phenotype • Cardiac rehabilitation
• Registered dietitian nutritionist
evaluation for malnutrition
Social Barriers
Financial burden
of HF treatments
• COmprehensive Score
for financial Toxicity–
Functional Assessment of
Chronic Illness Therapy
(COST-FACIT)
• PharmD referral to review
prescription assistance eligibilities
Food insecurity • Hunger Vital Sign, 2 items
• U.S. Household Food
Security Survey Module,
6 items
• Determine eligibility for
the Supplemental Nutrition
Assistance Program (SNAP)
• Connect patients with
community partners such as food
pantries/food banks
• Home meal deliveries
• Registered dietitian nutritionist
evaluation for potential
malnutrition
Homelessness
or housing
insecurity
• Homelessness Screening
Clinical Reminder
(HSCR)
• Referral to local housing services
• Connect patients with
community housing partners
