Multidisciplinary Approach in Heart Failure: Evidence, Experiences and Challenges

Abstract

A multidisciplinary approach is increasingly implemented in optimizing treatment and care for Heart Failure patients. Such a multidisciplinary approach is often used in disease management programs. During the last decade several randomized clinical trials have been published on successful disease management programs in heart failure patients that can decrease readmission rates and significantly improve other outcomes such as quality of life and symptoms. Several innovative initiatives have been developed to improve health outcomes of heart failure patients. Although in several countries disease management programmes for patients with heart failure exist, there is a large variability in the application of these programs, depending on national recourses and capabilities. In most disease management programs a multidisciplinary approach is used with important roles for heart failure nurses and cardiologists. Key components often include: physical examination, telephone consultation, patient education, drug titration and diagnostic testing. Although the most optimal model of disease management in heart failure still is not known, several models have proven to be successful in specific settings such as a heart failure clinic, a home based program or a multidisciplinary team approach including both primary and secondary care. The recently published COACH trial has provided new insights in the implementation of disease management programs and gives new insight in the challenges with the multidisciplinary approach. In the current presentation evidence of a multidisciplinary approach in heart failure will be discussed: evidence, experiences and challenges of a multidisciplinary approach will be reviewed.