Improving the Management of Outpatients with Heart Failure the IC-MMERSIVE Project

Objectives: Design strategies to improve management, outcomes, and quality of life for people with heart failure (HF) in Spain through the identification of areas of improvement regarding diagnosis, treatment, comorbidities, progression of disease and healthcare coordination between specialists. Methods: IC-MMERSIVE project was developed by the Cardiology and Primary Care Integration Working Group of the Spanish Society of Cardiology. The project included a pre-session survey for participants, face-to-face sessions led by a clinical cardiologist, and post-session questionnaires for the moderator and for participants. A web platform was created to host program content and resources and electronic forms for data collection and analysis. Results: A total of 1186 physicians (80.5% cardiologists) participated in 144 face-to-face sessions throughout Spain. When patients are at risk for HF (HF stage B), 78.9% of respondents said they proactively search for HF. Only 38.0% were familiar with and applied the IC-BERG study questions designed to detect falsely stable patients. Specific protocols for optimizing and implementing the four pharmacologic pillars of treatment for HF were used by 51.6% of participants, 53.9% had protocols to reach the guideline-recommended target doses, and 25.6% reported no nursing involvement. Structured follow-up was conducted in 53.9% of cases. Even though 63.0% used shared single medical records, the connection between specialized HF consultations and healthcare centers was occasional in 72.1% of cases. Conclusions: There is marked room to improve HF management in daily clinical practice. These findings highlight specific actionable gaps in HF management and support the need for structured, multidisciplinary strategies to improve patient outcomes.