Summary: | Heart Failure (HF) is characterized by an elevated readmission rate, with almost
50% of events occurring after the first episode over the first 6 months of the
post-discharge period. In this context, the vulnerable phase represents the
period when patients elapse from a sub-acute to a more stabilized chronic phase.
The lack of an accurate approach for each HF subtype is probably the main cause
of the inconclusive data in reducing the trend of recurrent hospitalizations.
Most care programs are based on the main diagnosis and the HF stages, but a model
focused on the specific HF etiology is lacking. The HF clinic route based on the
HF etiology and the underlying diseases responsible for HF could become an
interesting approach, compared with the traditional programs, mainly based on
non-specific HF subtypes and New York Heart Association class, rather than on
detailed etiologic and epidemiological data. This type of care may reduce the
30-day readmission rates for HF, increase the use of evidence-based therapies,
prevent the exacerbation of each comorbidity, improve patient compliance, and
decrease the use of resources. For all these reasons, we propose a dedicated
outpatient HF program with a daily practice scenario that could improve the early
identification of symptom progression and the quality-of-life evaluation,
facilitate the access to diagnostic and laboratory tools and improve the
utilization of financial resources, together with optimal medical titration and
management.
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