Worldwide evidence says better care will halt heart failure epidemic

Aug 23 2004

An international team of researchers from Australia, Canada, Italy and Scotland studying the results of heart failure management have found that managed care from specialist teams of health professionals can improve survival rates by up to 25 per cent.

The team studied the results of 29 controlled trials of heart failure management programs involving over 5000 patients at high risk for multiple hospital admissions and premature death.

In a paper published in the latest issue of the Journal of the American College of Cardiology, one of the most prestigious and influential medical journals in the world, the authors reported the combined results of these studies on hospital admissions and deaths during study follow-up.

The research found that specialist teams of health professionals who work together to improve the management of heart failure in an increasing number of typically old and fragile patients are able to achieve the following:

• improve survival rates by 25 per cent;
• reduce hospitalization rates by 20-26 per cent;
• improve patient quality of life; and
• reduce health care costs.

UniSA Chair in Cardiovascular Nursing and Australian partner in the study, Professor Simon Stewart, says this is the first combined analysis to provide such strong evidence in favour of applying heart failure management programs of care to every patient with heart failure at high risk for poor health outcomes.

“Significantly, heart failure – a deadly condition that reflects the heart’s inability to pump enough blood around the body – is a modern-day epidemic that is the most common cause of hospital admissions in those aged 65 years or more,” Professor Stewart said.

“This epidemic also accounts for about two per cent of all health care expenditure in developed countries.

“Specialist heart failure management programs, involving a key role for specialist nurses, cardiologists, general practitioners, pharmacists and other health professionals, who manage patients either via an outpatient clinic or in their own home have been developed and applied widely in almost every developed country.

“But despite the life and cost saving evidence, getting sustained funding for these programs is often difficult. At the moment only a fraction of patients who would benefit from access to this specialist team care approach have access to that care.”