WMJ Vol 124 Issue 2: Climate Change Vulnerability and Opportunities for Adaptive Capacity in Patients with Heart Failure in an Ambulatory Setting

ABSTRACT

Introduction: Climate change, a global crisis, affects health through changes such as more intense and longer lasting heatwaves. Some populations are more vulnerable to such events, including those with certain medical conditions, like heart failure. This study aimed to improve understanding of heat-related vulnerabilities and opportunities to enhance adaptive capacity of patients within an ambulatory heart failure clinic.

Methods: Heart failure clinic patients at the Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin, voluntarily completed a 25-question multiple-choice survey. We present descriptive statistics of the survey responses with count and percentage for categorical responses.

Results: We found that out of 60 survey respondents, 46.55% agreed or strongly agreed they would benefit from discussing heat illness risks with their physician, and 31.58% were not aware their heat illness risk is higher on days hotter than 90 °F (32.2 °C). Several vulnerability factors were common: 70.69% follow a prescribed fluid restriction, 33.33% live alone, 20.34% lack a car with air conditioning, and 20.00% worry about their ability to pay electric bills. Notable knowledge gaps included 65% do not check forecasted temperatures, 60% do not plan activities for the coolest times of day, 43.10% lacked awareness of cooling centers, 33.33% were unsure of heat illness symptoms, and 27.12% lacked awareness of Wisconsin’s Focus on Energy program.

Conclusions: A sizable portion of survey respondents indicated they would benefit from discussing their heat illness risk with their clinicians, and many underestimated their personal risk of heat illness. Additionally, multiple vulnerability factors were highly prevalent and knowledge gaps were demonstrated in this population. Our findings support adaptive capacity opportunities through heat illness education, anticipatory guidance, and increased resource awareness for patients with heart failure in an ambulatory setting.

Intended Audience

The intended audience for this continuing education activity is healthcare professionals caring for the people of Wisconsin and beyond.

Learning Objectives

As a result of participating in this journal-based activity, healthcare team members will be able to:

  1. Explain heat-related vulnerabilities and factors influencing heat illness risk in patients with heart failure.
  2. Summarize survey findings related to heat illness risk awareness, prevalence of vulnerability factors, and resource gaps among patients with heart failure.
  3. Discuss the role of healthcare teams in improving adaptive capacity among patients with heart failure through patient education, clinical guidance, and connection to community resources (e.g., cooling centers, energy assistance programs).
Course summary
Available credit: 
  • 0.75 AAPA Category 1 CME
  • 0.75 AMA PRA Category 1 Credit
  • 0.75 ANCC Contact Hours
  • 0.75 University of Wisconsin–Madison Continuing Education Hours
    • 0.75 Approved for AMA PRA Category 1 Credit™
Registration opens: 
05/26/2026
Course expires: 
05/25/2027
Cost:
$0.00
Rating: 
0

FACULTY DISCLOSURE

It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the  speakers/presenters, authors, planners, and other persons who may influence the content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.

For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.

Name of IndividualIndividual's Role in ActivityFinancial Relationship DisclosureDiscussion of Unlabeled/Unapproved Uses of Drugs/Devices
Marianna Shershneva, MD, PhDAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
James Eberhard, MFAAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
Rachel Heschke, MDAuthorNo relevant relationships with ineligible companies to discloseNo
Abigail Thorgerson, MPHAuthorNo relevant relationships with ineligible companies to discloseNo
Margaret Angeli, APNPAuthorNo relevant relationships with ineligible companies to discloseNo
Joanne Bernstein, MD, MSEAuthorNo relevant relationships with ineligible companies to discloseNo
Venkata Manchala, MDReviewerNo relevant relationships with ineligible companies to discloseNo
Kurtis J. SwansonReviewerNo relevant relationships with ineligible companies to discloseNo
Fahad Aziz, MDEditorNo relevant relationships with ineligible companies to discloseNo
Sue Wenker, PT, PhD, MS, FNAPReviewerNo relevant relationships with ineligible companies to discloseNo
Laura Ozkan, PAReviewerNo relevant relationships with ineligible companies to discloseNo
Caitlin Weitzel, APNP, ACNP, MSNReviewerNo relevant relationships with ineligible companies to discloseNo

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients. The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.

Discloser List CME Internal Report

Accreditation and Credit Designation Statements

Accreditation Logos

Accreditation Statements

In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal.  The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
 

American Medical Association (AMA)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 0.75 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

American Nurses Credentialing Center (ANCC)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 0.75 ANCC contact hours.  

American Academy of Physician Assistants (AAPA)

The University of Wisconsin–Madison ICEP has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.75 AAPA Category 1 CME credits. Approval is valid until 03/25/2027. PAs should only claim credit commensurate with the extent of their participation.

 

Continuing Education Units

The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.075 continuing education units (CEUs) or 0.75 hours.

Available Credit

  • 0.75 AAPA Category 1 CME
  • 0.75 AMA PRA Category 1 Credit
  • 0.75 ANCC Contact Hours
  • 0.75 University of Wisconsin–Madison Continuing Education Hours
    • 0.75 Approved for AMA PRA Category 1 Credit™

Cost:
$0.00
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