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[Management programs for elderly patients with chronic heart failure]
G Pulignano1, E Carmenini, D Del Sindaco
1Dipartimento di Cardioscienze, Osp. S. Camillo, Roma, Italy. gipulig@tin.it
Purpose:
Most patients with heart failure are elderly with multiple coexisting diseases and heart failure is the most common discharge diagnosis in elderly hospitalized patients. Despite major advances in the pharmacotherapy of heart failure, hospitalization rates remain high, owing in large part to a multitude of psychosocial, behavioral, and financial factors that serve as barriers to effective compliance with prescribed treatment. In the last decade, several models have been proposed in order to optimise the long-term management of elderly patients with heart failure.
Design:
A review of most significant and recent models available was performed.
Results:
Several studies have documented the efficacy of specialized multidisciplinary heart failure disease management programs in terms of reducing hospital utilization, improving quality of life, functional capacity, patient satisfaction, compliance with diet and medications and decreasing cost of care.
Conclusions:
At present, the greatest challenge in managing elderly heart failure patients is to more effectively implement proven treatments and disease management systems.