Optimizing outcomes in heart failure: 2022 and beyond.

Area of Science:

• Cardiology
• Healthcare Management
• Clinical Practice Improvement

Background:

• Despite advances in heart failure (HF) therapies, clinical practice often falls short of ideal management.
• A European Society of Cardiology (ESC) workshop identified key barriers to optimal HF care implementation.

Purpose of the Study:

• To identify barriers hindering the effective implementation of heart failure therapies and guidelines.
• To propose mitigation strategies for improving patient outcomes in heart failure management.

Main Methods:

• Convened a Cardiovascular Round Table workshop by the ESC.
• Discussed challenges including HF complexity, financial constraints, patient needs, outpatient care, and healthcare fragmentation.
• Reviewed ongoing initiatives like ESC guidelines, quality indicators, registries, and patient definitions.
• Identified priority actions such as revised HF phenotypes, implementation strategies, affordability, regulator/payer involvement, patient education, and primary care integration.

Main Results:

• Key barriers identified: HF complexity, treatment costs, unmet patient needs, suboptimal outpatient care, and fragmented systems.
• Existing initiatives (2021 ESC HF guideline, quality indicators, registries) offer partial solutions.
• Priority actions include revised HF phenotypes, implementation strategies, improved affordability, increased patient education, and enhanced primary care integration.

Conclusions:

• Overarching changes are needed to improve heart failure care models.
• A standardized pathway with a digital backbone, decision support, and data integration is proposed.
• This integrated model aims to adapt and improve as HF management evolves.