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Media Release

August 20, 2004

Worldwide evidence says better care will halt heart failure epidemic

An international team of researchers from Australia, Canada, Italy and Scotland studying the results of heart failure management have found that managed care from specialist teams of health professionals can improve survival rates by up to 25 per cent.

The team studied the results of 29 controlled trials of heart failure management programs involving over 5000 patients at high risk for multiple hospital admissions and premature death.

In a paper published in the latest issue of the Journal of the American College of Cardiology, one of the most prestigious and influential medical journals in the world, the authors reported the combined results of these studies on hospital admissions and deaths during study follow-up.

The research found that specialist teams of health professionals who work together to improve the management of heart failure in an increasing number of typically old and fragile patients are able to achieve the following:

UniSA Chair in Cardiovascular Nursing and Australian partner in the study, Professor Simon Stewart, says this is the first combined analysis to provide such strong evidence in favour of applying heart failure management programs of care to every patient with heart failure at high risk for poor health outcomes.

“Significantly, heart failure – a deadly condition that reflects the heart’s inability to pump enough blood around the body – is a modern-day epidemic that is the most common cause of hospital admissions in those aged 65 years or more,” Professor Stewart said.

“This epidemic also accounts for about two per cent of all health care expenditure in developed countries.

“Specialist heart failure management programs, involving a key role for specialist nurses, cardiologists, general practitioners, pharmacists and other health professionals, who manage patients either via an outpatient clinic or in their own home have been developed and applied widely in almost every developed country.

“But despite the life and cost saving evidence, getting sustained funding for these programs is often difficult. At the moment only a fraction of patients who would benefit from access to this specialist team care approach have access to that care.”

Publication

McAlister FA, Stewart S, Ferrua S, McMurray JJV, 'Multidisciplinary strategies for the management of heart failure patients at high risk for admission,' Journal of the American College of Cardiology 2004;44:810-19.

More information

Author comments
Professor Simon Stewart, National Heart Foundation Chair of Cardiovascular Nursing at the University of South Australia, mobile 0438 302 111

Prof Stewart, whose own seminal studies of multidisciplinary, home-based intervention in heart failure were included in this combined analysis believes that the results of this study provide compelling evidence that specialist teams are critical to dealing with an epidemic of heart failure in Australia.

Indeed, if this highly cost-effective treatment were available in tablet form, every patient with heart failure would expect the Federal Government to provide the funding so that they could receive the substantial benefits it provides. The fact that specialist teams, unlike most other forms of treatment, reduce rather than increase costs in treating heart failure, provides a compelling reason why this should be the case.

Comments from the National Heart Foundation of Australia
Donna Le Page office (03) 9645 7011 mobile (0412) 797 937 email donna@lepage-pr.com.au

Comment from the National Institute of Clinical Studies
The National Institute of Clinical Studies congratulates Professor Stewart and his international colleagues on the findings of this systematic review.

NICS is Australia’s national agency for improving health care by helping close important gaps between best available evidence and current clinical practice. Amongst its priority programs, NICS is undertaking a major heart failure program which aims to increase the use of research evidence in the diagnosis and management of heart failure in order to improve the quality of care for patients.

We already have high level evidence about how we should treat heart failure patients. Solid evidence about how we can improve the delivery of best practice care, such as the findings of this systematic review, is critical for clinicians and policy makers. This latest research provides valuable high level evidence showing that the use of strategies that incorporate follow up of high risk heart failure patients by a specialised multidisciplinary team reduce mortality, as well as hospitalisations.

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