This guide provides practical recommendations for implementing integrated home-based care for heart failure patients, emphasizing multidisciplinary teams, patient education, and individualized care plans.
Adoption of multidisciplinary integrated home care with education and self-management is warranted in heart failure; extends Level 1 evidence into actionable guideline recommendations.
INTRODUCTION: Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis, and it is also costly for society. Better integrated care is warranted in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. METHOD: We developed a guide on Home Health in Heart Failure patients from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. RESULTS: IN INTEGRATED HOME CARE FOR HEART FAILURE PATIENTS, IT IS ADVISED TO CONSIDER THE FOLLOWING COMPONENTS: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. DISCUSSION: We summarised the state of the art of home-based care for heart failure patients in Europe, described the typical content of such care to provide a guide for health care providers.
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Jaarsma et al. (2013) conducted a review in Heart failure. Integrated home-based heart failure care was evaluated. Integrated home care for heart failure patients should include multidisciplinary care, patient participation, care plans, education, self-care management, appropriate access, and optimized treatment.
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