Skip to main content
Log in

Disease Management Programs for Heart Failure

  • Valvular, Myocardial, Pericardial, and Cardiopulmonary Diseases
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion statement

The impact of the very significant advances in the management of heart failure over the past several decades had been limited by a lack of appropriate infrastructure for heart failure care delivery in the community. The development of disease management programs has brought about significant advances in ensuring improved care of the wider heart failure population, allowing for effective prescription of proven strategies, structured follow-up, and education of patients and families to encourage involvement in self-care. The impact of these programs on reduction in hard cardiovascular endpoints, including death and heart failure rehospitalization, has been substantial. Continued research aims to optimize this strategy in terms of what additional aspects are necessary to enhance this approach. From recent work, it is clear that heart failure patients may derive incremental benefit from exercise programs as an adjunctive therapy; additional work is required to address how we should use the rapidly developing home telemonitoring technologies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Cohn JN, Archibald DG, Ziesche S, et al.: Effect of vasodilator therapy on mortality in chronic congestive heart failure: results of a Veterans Administration Cooperative Study (VA-HeFT). N Engl J Med 1986, 314:1547–1552.

    Article  CAS  PubMed  Google Scholar 

  2. Roccaforte R, Demers C, Baldassarre F, et al.: Effectiveness of comprehensive disease management programmes in improving clinical outcomes in heart failure patients. A meta-analysis. Eur J Heart Fail 2005, 7:1133–1144.

    Article  PubMed  Google Scholar 

  3. Rich MW, Beckham V, Wittenberg C, et al.: A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med 1995, 333:1190–1195.

    Article  CAS  PubMed  Google Scholar 

  4. Cleland JC, Louis AA, Rigby AS, for the TENS-HMS Investigators, et al.: Non Invasive home telemonitoring for patients with heart failure at high risk for recurrent admission and death. J Am Coll Cardiol 2005, 45:1654–1664.

    Article  PubMed  Google Scholar 

  5. van der Wal MH, Jaarsma T, van Veldhuisen DJ: Non-compliance in patients with heart failure; how can we manage it? Eur J Heart Fail 2005, 7:5–17.

    Article  PubMed  Google Scholar 

  6. Phelan D, Smyth L, Ryder M, et al.: Can we reduce preventable heart failure readmissions in patients enrolled in a Disease Management Programme? Ir J Med Sci 2009, 178:167–171.

    Article  CAS  PubMed  Google Scholar 

  7. Klersy C, De Silvestri A, Gabutti G, et al.: A meta-analysis of remote monitoring of heart failure patients. J Am Coll Cardiol 2009, 54:1683–1694.

    Article  PubMed  Google Scholar 

  8. Catanzariti D, Lunati M, Landolina M, on behalf of the Italian Clinical SERVICE Optivol –CRT Group, et al.: Monitoring intrathoracic impedance with and implantable defibrillator reduces hospitalizations in patients with heart failure. PACE 2009, 32:363–370.

    PubMed  Google Scholar 

  9. Cowie M, Conraads V, Tavazzi L, Yu CM, on behalf of the SENSE-HF Investigators: Rationale and design of a prospective trial to assess the sensitivity and positive predictive value o implantable intrathoracic impedance monitoring in the prediction of heart failure hospitalizations. J Card Failure 2009, 15:394–400.

    Article  Google Scholar 

  10. Kataoka HA: New monitoring method for the estimation of body fluid status by digital weight scale incorporating bioelectrical impedance analyzer in definite heart failure patients. J Card Fail 2009, 15:410–415.

    Article  PubMed  Google Scholar 

  11. Valle R, Aspromonte N: Use of brain natriuretic peptide and bioimpedance to guide therapy in heart failure patients. fluid overload; diagnosis and management. Contrib Nephrol 2010, 164:209–216.

    Article  PubMed  Google Scholar 

  12. Ambardekar AV, Fonarow GC, Hernandez AF, et al.: Get With the Guidelines Steering Committee and Hospitals: Characteristics and in-hospital outcomes for nonadherent patients with heart failure: findings from Get With The Guidelines-Heart Failure (GWTG-HF). Am Heart J 2009, 158:644–652.

    Article  PubMed  Google Scholar 

  13. Granger BB, Ekman I, Granger CB, et al.: Adherence to medication according to sex and age in the CHARM programme. Eur J Heart Failure 2009, 11:1092–1098.

    Article  Google Scholar 

  14. Lamb DA, Eurich DT, McAlister FA, et al.: Changes in adherence to evidence-based medications in the first year after initial hospitalization for heart failure: observational cohort study from 1994 to 2003. Circ Cardiovasc Qual Outcome 2009, 2:228–235.

    Article  Google Scholar 

  15. Yancy CW, Fonarow GC, Albert NM, et al.: Adherence to guideline-recommended adjunctive heart failure therapies among outpatient cardiology practices (findings from IMPROVE HF). Am J Cardiol 2010, 15:255–260.

    Article  Google Scholar 

  16. van der Wal MH, van Veldhuisen DJ, Veeger NJ, et al.: Compliance with non-pharmacological recommendations and outcome in heart failure patients. Eur Heart J 2010, 31:1486–1493.

    Article  PubMed  Google Scholar 

  17. Patterson ME, Hernandez AF, Hammill BG, et al.: Process of care performance measures and long-term outcomes in patients hospitalized with heart failure. Med Care 2010, 48:210–216.

    Article  PubMed  Google Scholar 

  18. Hernandez AF, Hammill BG, Peterson ED, et al.: Relationships between emerging measures of heart failure processes of care and clinical outcomes. Am Heart J 2010, 159:406–417.

    Article  PubMed  Google Scholar 

  19. O’Connor CM, Whellan DJ, Lee KL, for the HF-ACTION Investigators, et al.: Efficacy and safety of exercise training in patients with chronic heart failure; HF-ACTION randomized controlled trial. JAMA 2009, 301:1439–1450.

    Article  PubMed  Google Scholar 

  20. Flynn KE, Piña IL, Whellan DJ, et al.: effects of exercise training on health status in patients with chronic heart failure: findings from the HF-ACTION randomized controlled trial. JAMA 2009, 301:1541–1549.

    Article  Google Scholar 

  21. Davies EJ, Moxham T, Rees K, et al.: Exercise training for systolic heart failure: Cochrane systematic review and meta-analysis. Eur J Heart Failure 2010, 12:706–715.

    Article  Google Scholar 

  22. Mårtensson J, Dahlström U, Johansson G, et al.: Nurse-led heart failure follow-up in primary care in Sweden. Eur J Cardiovasc Nurs 2009, 8:119–124.

    Article  PubMed  Google Scholar 

  23. Jaarsma T, Arestedt KF, Mårtensson J, et al.: The European Heart Failure Self-care Behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument. Eur J Heart Fail 2009, 11:99–105.

    Article  PubMed  Google Scholar 

  24. Hoekstra T, Lesman-Leegte I, van der Wal M, et al.: Nurse-led interventions in heart failure care: Patient and nurse perspectives. Eur J Cardiovasc Nurs 2010 Mar 2 [Epub ahead of print].

  25. Smoulders ES, van Haastregt JC, Ambergen T, et al.: Nurse-led self-management group programme for patients with congestive heart failure: randomized controlled trial. J Adv Nurs 2010 May 21 [Epub ahead of print].

Download references

Disclosure

No potential conflict of interest relevant to this article was reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ken McDonald MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

McDonald, K. Disease Management Programs for Heart Failure. Curr Treat Options Cardio Med 12, 578–586 (2010). https://doi.org/10.1007/s11936-010-0094-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11936-010-0094-5

Keywords

Navigation