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A systematic approach to chronic heart failure care: a consensus statement

Karen Page, Thomas H Marwick, Rebecca Lee, Robert Grenfell, Walter P Abhayaratna, Anu Aggarwal, Tom G Briffa, Jan Cameron, Patricia M Davidson, Andrea Driscoll, Jacquie Garton-Smith, Debra J Gascard, Annabel Hickey, Dariusz Korczyk, Julie-Anne Mitchell, Rhonda Sanders, Deborah Spicer, Simon Stewart and Vicki Wade
Med J Aust 2014; 201 (3): 146-150. || doi: 10.5694/mja14.00032

Summary

  • The National Heart Foundation of Australia assembled an expert panel to provide guidance on policy and system changes to improve the quality of care for people with chronic heart failure (CHF). The recommendations have the potential to reduce emergency presentations, hospitalisations and premature death among patients with CHF.
  • Best-practice management of CHF involves evidence-based, multidisciplinary, patient-centred care, which leads to better health outcomes. A CHF care model is required to achieve this.
  • Although CHF management programs exist, ensuring access for everyone remains a challenge. This is particularly so for Aboriginal and Torres Strait Islander peoples, those from non-metropolitan areas and lower socioeconomic backgrounds, and culturally and linguistically diverse populations.
  • Lack of data and inadequate identification of people with CHF prevents efficient patient monitoring, limiting information to improve or optimise care. This leads to ineffectiveness in measuring outcomes and evaluating the CHF care provided. Expanding current cardiac registries to include patients with CHF and developing mechanisms to promote data linkage across care transitions are essential.
  • As the prevalence of CHF rises, the demand for multidisciplinary workforce support will increase. Workforce planning should provide access to services outside of large cities, one of the main challenges it is currently facing.
  • To enhance community-based management of CHF, general practitioners should be empowered to lead care. Incentive arrangements should favour provision of care for Aboriginal and Torres Strait Islander peoples, those from lower socioeconomic backgrounds and rural areas, and culturally and linguistically diverse populations.
  • Ongoing research is vital to improving systems of care for people with CHF. Future research activity needs to ensure the translation of valuable knowledge and high-quality evidence into practice.

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  • Karen Page1
  • Thomas H Marwick2
  • Rebecca Lee1
  • Robert Grenfell1
  • Walter P Abhayaratna3
  • Anu Aggarwal4
  • Tom G Briffa5
  • Jan Cameron6
  • Patricia M Davidson7
  • Andrea Driscoll8
  • Jacquie Garton-Smith9
  • Debra J Gascard10
  • Annabel Hickey11
  • Dariusz Korczyk12
  • Julie-Anne Mitchell13
  • Rhonda Sanders14
  • Deborah Spicer15
  • Simon Stewart16
  • Vicki Wade13

  • 1 National Heart Foundation of Australia, Melbourne, VIC.
  • 2 Menzies Research Institute Tasmania, Hobart, TAS.
  • 3 Canberra Hospital, Canberra, ACT.
  • 4 Royal Melbourne Hospital, Melbourne, VIC.
  • 5 School of Population Health, University of Western Australia, Perth, WA.
  • 6 Cardiovascular Research Centre, Australian Catholic University, Melbourne, VIC.
  • 7 Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW.
  • 8 Faculty of Health, Deakin University, Melbourne, VIC.
  • 9 Cardiovascular Health Network, Department of Health Western Australia, Perth, WA.
  • 10 Heart Failure Care, Monash Health, Melbourne, VIC.
  • 11 Advanced Heart Failure and Cardiac Transplant Unit, The Prince Charles Hospital, Brisbane, QLD.
  • 12 Heart Failure Unit, Princess Alexandra Hospital, Brisbane, QLD.
  • 13 National Heart Foundation of Australia, Sydney, NSW.
  • 14 Department of Cardiology, St Vincent's Hospital Melbourne, Melbourne, VIC.
  • 15 Community Heart Failure Nursing, Southern Adelaide Local Health Network, Adelaide, SA.
  • 16 Baker IDI Heart and Diabetes Institute, Melbourne, VIC.


Acknowledgements: 

We thank Rohan Greenland for his contribution to the content of this document.

Competing interests:

Thomas Marwick is supported in part by a National Health and Medical Research Council Partnership grant (1059738). Simon Stewart declares an unrestricted education grant from Novartis Pharmaceuticals Australia, provided to the Baker IDI Heart and Diabetes Institute, to undertake a burden of disease in Australia report. He also received consulting fees from Novartis and payment from Menarini Australia for his involvement on an advisory board relevant to the treatment of heart failure. The National Heart Foundation of Australia supported all authors to attend the expert panel meeting held in Melbourne, through payment of travel and accommodation costs.

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