In Europe, the heart failure (IC) has taken on a relevant role in the health system in recent years, affecting approximately 15 million Europeans and accounting for between one and two percent of health costs. This has been pointed out by Ed Harding, strategic advisor to the Heart Failure Policy Network (HFPN), during the presentation of the report ‘Spotlight on worsening heart failure‘ organized by Bayeron the occasion of the Congress of the European Society of Cardiology (ESC) 2022.
According to the results that emerge from the report, this disease -which is characterized by a condition of the heart being “too” weak that prevents it from pumping enough blood to the rest of the body— has gotten worse. In fact, HF hospitalizations have increased by 70 percent due to worsening of the disease itself, and hospitalization now accounts for almost 90 percent of all direct costs of heart failure in Europe.
Worsening of HF is a decompensation event in which a patient requires intravenous diuretics or hospitalizationand may mark an upward spiral of disease progression. In fact, the report shows that one in five patients dies within two years of a worsening heart failure event.
Hospitalizations for HF have increased by 70% due to worsening of the disease itself
“One of the top priorities in heart failure is avoid hospitalization, but once it happens and the patient is discharged, we want to make sure they don’t need to come back. HF worsening events are important moments to use therapeutic tools that we have at our disposal”, explained Harding.
“We also need to develop effective discharge protocols to ensure more efficient care,” added Harding. Readmissions for heart failure are high if the disease is not treated correctly. Currently, many patients also do not receive specialist care or constant follow-up, two clear structural barriers that we see in practice today.”
Keys to prevent and avoid hospitalizations
Faced with this situation, Harding has offered a series of solutions, belonging to the report, with which to prevent the worsening of heart failure events and keep the population out of the hospital.
Although it is a disease that affects millions of people and It is expected that one in five Europeans is diagnosed with heart failurethe HFPN strategic adviser has warned that there is low awareness among the general population and professionals, so it would be advisable increase knowledge of the disease and implement clear clinical guidance.
“Warning signals are shortness of breath, swollen limbs, and extreme fatigue“, the advisor recalled.
Likewise, the expert has pointed out that access to optimal treatment to reduce the symptoms of worsening heart failure is limited. For this reason, Harding explained, “you must finance guideline-based care and ensure platforms such as telemonitoring, which can support this care”.
The warning signs are shortness of breath, swollen limbs, and extreme fatigue
On the other hand, Harding has pointed out that residual symptoms of worsening HF may go unnoticed in hospital care. Therefore, the expert has suggested as a solution the implementation of effective hospital discharge protocols to improve results.
Investment and knowledge, key in CI
As the report points out, Harding has highlighted the gap between management of acute heart failure and primary care as a key challenge in the worsening of HF care and shows that investment in multidisciplinary teams can translate into improvements both in the results and in the quality of life of patients.
“HF specialist nurses provide person-centred care with which they can bridge this gap, being the main point of contact with patients across the full range of prevention, care management, patient treatment and education,” has the expert added.
In this same line, for the expert, worsening heart failure “often goes unrecognized due to lack of follow-up care after hospitalization.” To improve the results and costs generated by this worsening, Harding bets on the Outpatient care of worsening HF.
Like Harding, Lars Schwichtenberg, head of the heart disease therapeutic area at Bayer Pharmaceuticals, has recognized that, “while progress is being made to improve the treatment of heart failure, vital steps are needed to ensure that each patient receives the optimal care they deserve.”
HF worsening events are important moments to use therapeutic tools what we have at our disposal”
Ed HardingStrategic Advisor to the Heart Failure Policy Network
In the worsening of the disease, the lack of adherence and patient participation, according to Harding. Given this, the expert has proposed greater patient participation and a proactive care model.
Finally, for early detection of worsening heart failure and the implementation of best practice care, Harding has pointed out that, beyond increasing knowledge of the disease, it is necessary to promote the maintenance of the health of patients, as well as his out of hospital managementand improve access to advanced diagnostic tools and the reimbursement of guideline-recommended therapies.