Bouabdallaoui Nadia, Ducharme Anique
Department of Medicine, Montreal Heart Institute, Université de Montréal, 5000, Belanger East, Montreal, Quebec, H1T1C8, Canada.
Curr Heart Fail Rep. 2018 Dec;15(6):357-367. doi: 10.1007/s11897-018-0412-x.
Heart failure (HF) is the first cause of hospitalization in the elderly in Western countries, generating tremendous healthcare costs. Despite the spread of multidisciplinary post-discharge programs, readmission rates have remained unchanged over time. We review the recent developments in this setting.
Recent data plead for global reorganization of HF care, specifically targeting patients at high risk for further readmission, as well as a stronger involvement of primary care providers (PCP) in patients' care plan. Besides, tools, devices, and new interdisciplinary expertise have emerged to support and be integrated into those programs; they have been greeted with great enthusiasm, but their routine applicability remains to be determined. HF programs in 2018 should focus on pragmatic assessments of patients that will benefit the most from the multidisciplinary care; delegating the management of low-risk patients to trained PCP and empowering the patient himself, using the newly available tools as needed.
心力衰竭(HF)是西方国家老年人住院的首要原因,产生了巨大的医疗费用。尽管多学科出院后项目不断普及,但再入院率长期以来一直未变。我们综述了这方面的最新进展。
近期数据呼吁对HF护理进行全面重组,尤其针对有再次入院高风险的患者,同时让初级保健提供者(PCP)更深入地参与患者的护理计划。此外,已出现一些工具、设备和新的跨学科专业知识,以支持并融入这些项目;它们受到了极大的欢迎,但其常规适用性仍有待确定。2018年的HF项目应侧重于对患者进行务实评估,以便多学科护理能使患者最大程度受益;将低风险患者的管理委托给经过培训的PCP,并根据需要使用新可得的工具赋予患者自主权。