Disease management programs for heart failure.

The impact of the very significant advances in the management of heart failure over the past several decades had been limited by a lack of appropriate infrastructure for heart failure care delivery in the community. The development of disease management programs has brought about significant advances in ensuring improved care of the wider heart failure population, allowing for effective prescription of proven strategies, structured follow-up, and education of patients and families to encourage involvement in self-care. The impact of these programs on reduction in hard cardiovascular endpoints, including death and heart failure rehospitalization, has been substantial. Continued research aims to optimize this strategy in terms of what additional aspects are necessary to enhance this approach. From recent work, it is clear that heart failure patients may derive incremental benefit from exercise programs as an adjunctive therapy; additional work is required to address how we should use the rapidly developing home telemonitoring technologies.