Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers

Area of Science:

• Cardiology
• Public Health
• Healthcare Management

Background:

• Heart failure (HF) disease management programs (DMPs) are crucial for patient care.
• Understanding the components influencing HF-DMP effectiveness in Brazil is essential.

Purpose of the Study:

• To evaluate the impact of HF-DMP components on care and clinical decision-making in Brazil.
• To compare public versus private HF-DMPs and multidisciplinary (MHF) versus non-multidisciplinary (non-MHF) approaches.

Main Methods:

• An observational, cross-sectional study surveyed 98 cardiologists across Brazil.
• The survey included 29 questions on demographics, infrastructure, HF patient data, clinical management, performance indicators, and treatment perceptions.

Main Results:

• Public HF-DMPs showed significantly more dedicated services, multidisciplinary teams, educational programs, written discharge instructions, rehabilitation, monitoring, and guideline-directed medical therapy (GDMT-HF) use compared to private ones.
• Multidisciplinary HF-DMPs were associated with enhanced educational initiatives, written instructions, rehabilitation, and monitoring.
• Physicians adjusted medications based on hospitalizations or symptom worsening; treatment adherence was a major challenge.

Conclusions:

• HF-DMPs exhibit significant heterogeneity in Brazil.
• Future HF care strategies must incorporate insights from this study regarding clinical decision-making processes to enhance patient outcomes.