National heart failure strategies with measurable goals

We need

  • A single overarching national plan to address the growing burden of heart failure- either through existing cardiovascular (CVD) and chronic disease frameworks or heart failure – specific strategies
  • A concerted approach involving all relevant organisations, including patient representatives, professional bodies
  • A ‘whole system’ response to heart failure,1 covering all aspects related to prevention in those at risk, care and long-term management
  • Measurable goals rooted in evidence and which can be evaluated on a regular basis.

Why

  • Heart failure is a threat to the sustainability of healthcare systems:
    • The number of heart failure cases is expected to increase by 25% by 2030 (US figures)2
    • Heart failure is one of the few cardiovascular conditions where hospital admissions are increasing
  • Very few countries have national strategies specifically targeting heart failure.
  • Many of the challenges in solving this issue are strategic (e.g. investment in new professional roles, the need for multidisciplinary working, low public awareness) and need to be brought together in a cohesive plan ‘led from the top’.

 

Hospitalisations for cardiac diseases in Spain 3

graph-priority1-2

 

Trends in hospitalisations for heart failure4

Country Percentage change in number of hospitalisations Time period
France 14.4 2002 to 2008
Germany 39.8 2000 to 2007
Netherlands 21.0 2000 to 2010
Norway 2.4 1999 to 2008
Spain 22.3 2000 to 2011
Sweden 11.4 2001 to 2011
England -13.1 2001-02 to 2011-12

Source: adapted from Cowie 201484

Examples of what has been done:

  • Department of Health. National service framework: coronary heart disease. 2000

  • Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement From the American Heart Association. Circulation 2011.

  • González-Juanatey JR. La Enfermería en el Sistema Nacional de Salud - La Especialidad de Cardiología: “Una Responsabilidad de Todos", 2015.

  • Cowie MR, Anker SD, Cleland JG, et al. Improving care for patients with acute heart failure Before, during and after hospitalization. Heart Failure Association of the ESC 2014.

  • Ponikowski P, Anker S, AlHabib K, et al. Heart failure: preventing disease and death worldwide. : European Society of Cardiology., 2014.