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Erschienen in: Current Cardiology Reports 8/2023

12.07.2023 | Public Health Policy (SS Virani and D Mahtta, Section Editors)

Broadening Heart Failure Care Beyond Cardiology: Challenges and Successes Within the Landscape of Multidisciplinary Heart Failure Care

verfasst von: Michael Olson, Zachary Thompson, Lola Xie, Ajith Nair

Erschienen in: Current Cardiology Reports | Ausgabe 8/2023

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Abstract

Purpose of Review

Heart failure (HF) is a growing public health concern that impairs the quality of life and is associated with significant mortality. As the prevalence of heart failure increases, multidisciplinary care is essential to provide comprehensive care to individuals.

Recent Findings

The challenges of implementing an effective multidisciplinary care team can be daunting. Effective multidisciplinary care begins at the initial diagnosis of heart failure. The transition of care from the inpatient to the outpatient setting is critically important. The use of home visits, case management, and multidisciplinary clinics has been shown to decrease mortality and heart failure hospitalizations, and major society guidelines endorse multidisciplinary care for heart failure patients.

Summary

Expanding heart failure care beyond cardiology entails incorporating primary care, advanced practice providers, and other disciplines. Patient education and self-management are fundamental to multidisciplinary care, as is a holistic approach to effectively address comorbid conditions. Ongoing challenges include navigating social disparities within heart failure care and limiting the economic burden of the disease.
Literatur
5.
Zurück zum Zitat Fonarow GC, Committee ASA. The Acute Decompensated Heart Failure National Registry (ADHERE): opportunities to improve care of patients hospitalized with acute decompensated heart failure. Rev Cardiovasc Med. 2003;4(Suppl 7):S21-30.PubMed Fonarow GC, Committee ASA. The Acute Decompensated Heart Failure National Registry (ADHERE): opportunities to improve care of patients hospitalized with acute decompensated heart failure. Rev Cardiovasc Med. 2003;4(Suppl 7):S21-30.PubMed
7.
13.
Zurück zum Zitat • Bozkurt B, Fonarow GC, Goldberg LR, Guglin M, Josephson RA, Forman DE, Lin G, Lindenfeld J, O’Connor C, Panjrath G, Piña IL. Cardiac rehabilitation for patients with heart failure: JACC expert panel. J Am College Cardiol. 2021;77(11):1454-69. https://doi.org/10.1016/j.jacc.2021.01.030. This Expert Panel document outlines fundamental aspects of cardiac rehabilitation for the heart failure patient. • Bozkurt B, Fonarow GC, Goldberg LR, Guglin M, Josephson RA, Forman DE, Lin G, Lindenfeld J, O’Connor C, Panjrath G, Piña IL. Cardiac rehabilitation for patients with heart failure: JACC expert panel. J Am College Cardiol. 2021;77(11):1454-69. https://​doi.​org/​10.​1016/​j.​jacc.​2021.​01.​030. This Expert Panel document outlines fundamental aspects of cardiac rehabilitation for the heart failure patient.
14.
Zurück zum Zitat Van Spall HGC, Rahman T, Mytton O, Ramasundarahettige C, Ibrahim Q, Kabali C, Coppens M, Brian Haynes R, Connolly S. Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Eur J Heart Fail. 2017;19:1427–43. https://doi.org/10.1002/ejhf.765.CrossRefPubMed Van Spall HGC, Rahman T, Mytton O, Ramasundarahettige C, Ibrahim Q, Kabali C, Coppens M, Brian Haynes R, Connolly S. Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Eur J Heart Fail. 2017;19:1427–43. https://​doi.​org/​10.​1002/​ejhf.​765.CrossRefPubMed
18.
Zurück zum Zitat • McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JG. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Euro Heart J. 2021 Sep 21;42(36):3599-726. https://doi.org/10.1093/eurheartj/ehab368. The 2021 ESC Heart Failure Guidelines detail aspects of self-care and patient education. • McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JG. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Euro Heart J. 2021 Sep 21;42(36):3599-726. https://​doi.​org/​10.​1093/​eurheartj/​ehab368. The 2021 ESC Heart Failure Guidelines detail aspects of self-care and patient education.
19.
Zurück zum Zitat • Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am College Cardiol. 2022;79(17):e263-421. https://doi.org/10.1161/CIR.0000000000001063. The 2022 ACC/AHA/HFSA Heart Failure Guidelines outlines key aspects of multidisciplinary heart failure care. • Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am College Cardiol. 2022;79(17):e263-421. https://​doi.​org/​10.​1161/​CIR.​0000000000001063​. The 2022 ACC/AHA/HFSA Heart Failure Guidelines outlines key aspects of multidisciplinary heart failure care.
20.
Zurück zum Zitat Mebazaa A, Davison B, Chioncel O, Cohen-Solal A, Diaz R, Filippatos G, Metra M, Ponikowski P, Sliwa K, Voors AA, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet. 2022;400:1938–52. https://doi.org/10.1016/S0140-6736(22)02076-1.CrossRefPubMed Mebazaa A, Davison B, Chioncel O, Cohen-Solal A, Diaz R, Filippatos G, Metra M, Ponikowski P, Sliwa K, Voors AA, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet. 2022;400:1938–52. https://​doi.​org/​10.​1016/​S0140-6736(22)02076-1.CrossRefPubMed
25.
Zurück zum Zitat • Boureau AS, Annweiler C, Belmin J, Bouleti C, Chacornac M, Chuzeville M, David JP, Jourdain P, Krolak‐Salmon P, Lamblin N, Paccalin M. Practical management of frailty in older patients with heart failure: Statement from a panel of multidisciplinary experts on behalf the Heart Failure Working Group of the French Society of Cardiology and on behalf French Society of Geriatrics and Gerontology. ESC Heart Fail. 2022;9(6):4053-63. https://doi.org/10.1002/ehf2.14040. This statement from the French Society of Cardiology includes several methods to assess frailty in older patients with heart failure. • Boureau AS, Annweiler C, Belmin J, Bouleti C, Chacornac M, Chuzeville M, David JP, Jourdain P, Krolak‐Salmon P, Lamblin N, Paccalin M. Practical management of frailty in older patients with heart failure: Statement from a panel of multidisciplinary experts on behalf the Heart Failure Working Group of the French Society of Cardiology and on behalf French Society of Geriatrics and Gerontology. ESC Heart Fail. 2022;9(6):4053-63. https://​doi.​org/​10.​1002/​ehf2.​14040. This statement from the French Society of Cardiology includes several methods to assess frailty in older patients with heart failure.
30.
Zurück zum Zitat Parajuli DR, Kourbelis C, Franzon J, Newman P, McKinnon RA, Shakib S, Whitehead D, Clark RA. Effectiveness of the pharmacist-involved multidisciplinary management of heart failure to improve hospitalizations and mortality rates in 4630 patients: a systematic review and meta-analysis of randomized controlled trials. J Card Fail. 2019;25:744–56. https://doi.org/10.1016/j.cardfail.2019.07.455.CrossRefPubMed Parajuli DR, Kourbelis C, Franzon J, Newman P, McKinnon RA, Shakib S, Whitehead D, Clark RA. Effectiveness of the pharmacist-involved multidisciplinary management of heart failure to improve hospitalizations and mortality rates in 4630 patients: a systematic review and meta-analysis of randomized controlled trials. J Card Fail. 2019;25:744–56. https://​doi.​org/​10.​1016/​j.​cardfail.​2019.​07.​455.CrossRefPubMed
32.
Zurück zum Zitat • Rogers JG, Patel CB, Mentz RJ, Granger BB, Steinhauser KE, Fiuzat M, Adams PA, Speck A, Johnson KS, Krishnamoorthy A, Yang H. Palliative care in heart failure: the PAL-HF randomized, controlled clinical trial. J Am College Cardiol. 2017;70(3):331-41. https://doi.org/10.1016/j.jacc.2017.05.030. This study showed that Palliative Care improved quality of life and well-being in patients with heart failure. • Rogers JG, Patel CB, Mentz RJ, Granger BB, Steinhauser KE, Fiuzat M, Adams PA, Speck A, Johnson KS, Krishnamoorthy A, Yang H. Palliative care in heart failure: the PAL-HF randomized, controlled clinical trial. J Am College Cardiol. 2017;70(3):331-41. https://​doi.​org/​10.​1016/​j.​jacc.​2017.​05.​030. This study showed that Palliative Care improved quality of life and well-being in patients with heart failure.
33.
Zurück zum Zitat Riegel B, Moser DK, Buck HG, Dickson VV, Dunbar SB, Lee CS, Lennie TA, Lindenfeld J, Mitchell JE, Treat-Jacobson DJ, et al. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017;6. https://doi.org/10.1161/JAHA.117.006997. Riegel B, Moser DK, Buck HG, Dickson VV, Dunbar SB, Lee CS, Lennie TA, Lindenfeld J, Mitchell JE, Treat-Jacobson DJ, et al. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017;6. https://​doi.​org/​10.​1161/​JAHA.​117.​006997.
35.
Zurück zum Zitat Jonkman NH, Westland H, Groenwold RH, Agren S, Atienza F, Blue L, Bruggink-Andre de la Porte PW, DeWalt DA, Hebert PL, Heisler M, et al. Do self-management interventions work in patients with heart failure? An individual patient data meta-analysis. Circulation. 2016;133:1189–1198. https://doi.org/10.1161/CIRCULATIONAHA.115.018006. Jonkman NH, Westland H, Groenwold RH, Agren S, Atienza F, Blue L, Bruggink-Andre de la Porte PW, DeWalt DA, Hebert PL, Heisler M, et al. Do self-management interventions work in patients with heart failure? An individual patient data meta-analysis. Circulation. 2016;133:1189–1198. https://​doi.​org/​10.​1161/​CIRCULATIONAHA.​115.​018006.
42.
Zurück zum Zitat Bhatt AS, Varshney AS, Nekoui M, Moscone A, Cunningham JW, Jering KS, Patel PN, Sinnenberg LE, Bernier TD, Buckley LF, et al. Virtual optimization of guideline-directed medical therapy in hospitalized patients with heart failure with reduced ejection fraction: the IMPLEMENT-HF pilot study. Eur J Heart Fail. 2021;23:1191–201. https://doi.org/10.1002/ejhf.2163.CrossRefPubMed Bhatt AS, Varshney AS, Nekoui M, Moscone A, Cunningham JW, Jering KS, Patel PN, Sinnenberg LE, Bernier TD, Buckley LF, et al. Virtual optimization of guideline-directed medical therapy in hospitalized patients with heart failure with reduced ejection fraction: the IMPLEMENT-HF pilot study. Eur J Heart Fail. 2021;23:1191–201. https://​doi.​org/​10.​1002/​ejhf.​2163.CrossRefPubMed
43.
Zurück zum Zitat Krzesinski P, Jankowska EA, Siebert J, Galas A, Piotrowicz K, Stanczyk A, Siwolowski P, Gutknecht P, Chrom P, Murawski P, et al. Effects of an outpatient intervention comprising nurse-led non-invasive assessments, telemedicine support and remote cardiologists’ decisions in patients with heart failure (AMULET study): a randomised controlled trial. Eur J Heart Fail. 2022;24:565–77. https://doi.org/10.1002/ejhf.2358.CrossRefPubMed Krzesinski P, Jankowska EA, Siebert J, Galas A, Piotrowicz K, Stanczyk A, Siwolowski P, Gutknecht P, Chrom P, Murawski P, et al. Effects of an outpatient intervention comprising nurse-led non-invasive assessments, telemedicine support and remote cardiologists’ decisions in patients with heart failure (AMULET study): a randomised controlled trial. Eur J Heart Fail. 2022;24:565–77. https://​doi.​org/​10.​1002/​ejhf.​2358.CrossRefPubMed
46.
Zurück zum Zitat Zile MR, Bennett TD, St John Sutton M, Cho YK, Adamson PB, Aaron MF, Aranda JM, Jr., Abraham WT, Smart FW, Stevenson LW, et al. Transition from chronic compensated to acute decompensated heart failure: pathophysiological insights obtained from continuous monitoring of intracardiac pressures. Circulation. 2008;118:1433–1441. https://doi.org/10.1161/CIRCULATIONAHA.108.783910. Zile MR, Bennett TD, St John Sutton M, Cho YK, Adamson PB, Aaron MF, Aranda JM, Jr., Abraham WT, Smart FW, Stevenson LW, et al. Transition from chronic compensated to acute decompensated heart failure: pathophysiological insights obtained from continuous monitoring of intracardiac pressures. Circulation. 2008;118:1433–1441. https://​doi.​org/​10.​1161/​CIRCULATIONAHA.​108.​783910.
53.
56.
Zurück zum Zitat Segar MW, Rao S, Navar AM, Michos ED, Lewis A, Correa A, Sims M, Khera A, Hughes AE, Pandey A. County-level phenomapping to identify disparities in cardiovascular outcomes: an unsupervised clustering analysis: Short title: Unsupervised clustering of counties and risk of cardiovascular mortality. Am J Prev Cardiol. 2020;4:100118. https://doi.org/10.1016/j.ajpc.2020.100118. Segar MW, Rao S, Navar AM, Michos ED, Lewis A, Correa A, Sims M, Khera A, Hughes AE, Pandey A. County-level phenomapping to identify disparities in cardiovascular outcomes: an unsupervised clustering analysis: Short title: Unsupervised clustering of counties and risk of cardiovascular mortality. Am J Prev Cardiol. 2020;4:100118. https://​doi.​org/​10.​1016/​j.​ajpc.​2020.​100118.
66.
Zurück zum Zitat Morris AA, Khazanie P, Drazner MH, Albert NM, Breathett K, Cooper LB, Eisen HJ, O’Gara P, Russell SD, American Heart Association Heart F, et al. Guidance for timely and appropriate referral of patients with advanced heart failure: a scientific statement from the American Heart Association. Circulation. 2021;144:e238-e250. https://doi.org/10.1161/CIR.0000000000001016. Morris AA, Khazanie P, Drazner MH, Albert NM, Breathett K, Cooper LB, Eisen HJ, O’Gara P, Russell SD, American Heart Association Heart F, et al. Guidance for timely and appropriate referral of patients with advanced heart failure: a scientific statement from the American Heart Association. Circulation. 2021;144:e238-e250. https://​doi.​org/​10.​1161/​CIR.​0000000000001016​.
68.
Zurück zum Zitat Wang SY, Valero-Elizondo J, Ali HJ, Pandey A, Cainzos-Achirica M, Krumholz HM, Nasir K, Khera R. Out-of-pocket annual health expenditures and financial toxicity from healthcare costs in patients with heart failure in the United States. J Am Heart Assoc. 2021;10:e022164. https://doi.org/10.1161/JAHA.121.022164. Wang SY, Valero-Elizondo J, Ali HJ, Pandey A, Cainzos-Achirica M, Krumholz HM, Nasir K, Khera R. Out-of-pocket annual health expenditures and financial toxicity from healthcare costs in patients with heart failure in the United States. J Am Heart Assoc. 2021;10:e022164. https://​doi.​org/​10.​1161/​JAHA.​121.​022164.
69.
Zurück zum Zitat Gotanda H, Jha AK, Kominski GF, Tsugawa Y. Out-of-pocket spending and financial burden among low income adults after Medicaid expansions in the United States: quasi-experimental difference-in-difference study. BMJ. 2020;368:m40. https://doi.org/10.1136/bmj.m40. Gotanda H, Jha AK, Kominski GF, Tsugawa Y. Out-of-pocket spending and financial burden among low income adults after Medicaid expansions in the United States: quasi-experimental difference-in-difference study. BMJ. 2020;368:m40. https://​doi.​org/​10.​1136/​bmj.​m40.
Metadaten
Titel
Broadening Heart Failure Care Beyond Cardiology: Challenges and Successes Within the Landscape of Multidisciplinary Heart Failure Care
verfasst von
Michael Olson
Zachary Thompson
Lola Xie
Ajith Nair
Publikationsdatum
12.07.2023
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 8/2023
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-023-01907-5

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