Heart Failure Clinics Are Still Useful (More Than Ever?)

Abstract

Heart Failure (HF) clinics have had an important role in optimal HF management and the effectiveness of these clinics has been studied intensively. A HF clinic is one of the various ways to organize a HF disease management program. There is good evidence that HF disease management can improve outcomes in HF patients, but it is not clear what the optimal components of these programs are and what the relative effectiveness of a HF clinic is compared to other forms of HF management. After initial positive reports on the effect of HF clinics, these clinics were implemented in a lot of countries, although in different formats and of varying quality. In this paper we describe the initial need for HF clinics, reflect on their development over time and discuss the role of HF clinics in the current need for HF disease management.Introduction:

Cost-effectiveness of home versus clinic-based management of chronic heart failure: Extended follow-up of a pragmatic, multicentre randomized trial cohort — The WHICH? study (Which Heart Failure Intervention Is Most Cost-Effective & Consumer Friendly in Reducing Hospital Care)

“…Ultimately, what matters may be the quality, structure, component and availability of the follow-up rather than the location of follow-up [50] per se. If, however, the place of delivery such as home serves as a proxy of highly individualized care or a catalyst for changes needed to establish routines and patient's automaticity [51], the location or setting in which care is delivered could well be a key determinant of benefit.…”

Nurses’ attitudes toward family importance in heart failure care

“…RNs frequently meet family members to patients with HF in hospital-settings and in primary health care centres (PHCCs) and have a key role in meeting the needs of family members [13]. The quality of these encounters are likely to be influenced by the attitudes RNs hold toward families' role and the importance of their involvement in nursing care [14,15].…”

Follow-up care by a genetic counsellor for relatives at risk for cardiomyopathies is cost-saving and well-appreciated: a randomised comparison

“…First, in our study, most participants saw one only caregiver, whereas in previous studies examining the role of nurses in heart failure clinics, the patient was always seen by various caregivers, including a cardiologist. [4][5][6] Second, our study group consisted of symptom-free relatives, whereas previous studies covered patients diagnosed with a cardiac or other disease. Finally, the setting of our study differed from that of previous studies.…”

“…[4][5][6] It must be mentioned that genetic counsellors worldwide do not always have the same education. Although the genetic counsellor training programme in the Netherlands is organised differently compared witth those of other European nations, the competencies and skills acquired are similar to other European programmes.…”

“…[4][5][6] A study in low risk patients who had had a recent myocardial infarction demonstrated that nurse practitioners can deliver a quality of care equal to or better than conventional specialist care. 4 Improved survival and self-care behaviour was seen in patients with heart failure when they were treated by specially educated and experienced cardiac nurses.…”