Heart failure management systems in the Western Pacific Region: A rapid scoping review

Heart failure (HF) affects 64 million individuals globally and accounts for one quarter of non-communicable disease deaths in the Western Pacific Region (WPR). Indigenous populations, including Māori and Pacific Islander peoples, experience disproportionately higher HF morbidity and premature mortality. Evidence on HF management systems across Pacific Island Countries remains critically limited.

This rapid scoping review aimed to map and synthesise existing evidence on HF management systems across the WPR, including healthcare infrastructure, diagnostic and treatment modalities, guideline adherence, and patient outcomes.

A comprehensive search was conducted in PubMed, CINAHL, Web of Science, and Scopus for English-language articles published between 2000 and 2024. Grey literature from the WHO Western Pacific Regional Office and Pacific Island Ministries of Health was also searched. The review followed the PRISMA-ScR framework.

Two studies met all inclusion criteria. One study, from Papua New Guinea, identified critical deficits in guideline-directed pharmacological therapy, provider training, and pharmaceutical access for HF with reduced ejection fraction. The second study, from Aotearoa New Zealand, documented widening ethnic inequities in HF hospitalisation rates among Māori and Pacific Islander peoples between 2006 and 2018, with rates more than six times higher in those aged under 50 years compared to European counterparts.

No formalised HF management guidelines were identified across the WPR. Significant evidence gaps, health inequities, and implementation deficits persist across both resource-limited and higher-income settings. Urgent investment in primary research, culturally responsive policy development, and alignment with WHO HEARTS frameworks is needed to improve HF outcomes for Pacific peoples.