title: Heart failure management programmes in Europe.
abstract: BACKGROUND
  The ESC guidelines recommend that an organised system of specialist heart failure (HF) care should be established to improve outcomes of HF patients. The aim of this study was therefore to identify the number and the content of HF management programmes in Europe.
  
  
  METHODS
  A two-phase descriptive study was conducted: an initial screening to identify the existence of HF management programmes; and a survey to describe the content in countries where at least 30% of the hospitals had a programme.
  
  
  RESULTS
  Of the 43 European countries approached, 26 (60%) estimated the percentage of HF management programmes. Seven countries reported that they had such programmes in more than 30% of their hospitals. Of the 673 hospitals responding to the questionnaire, 426 (63%) had a HF management programme. Half of the programmes (n = 205) were located in an outpatient clinic. In the UK a combination of hospital and home-based programmes was common (75%). The most programmes included physical examination, telephone consultation, patient education, drug titration and diagnostic testing. Most (89%) programmes involved nurses and physicians. Multi-disciplinary teams were active in 56% of the HF programmes. The most prominent differences between the 7 countries were the degree of collaboration with home care and GP's, the role in palliative care and the funding.
  
  
  CONCLUSIONS
  Only a few European countries have a large number of organised programmes for HF care and follow up. To improve outcomes of HF patients throughout Europe more effort should be taken to increase the number of these programmes in all countries.
authors.affiliation: Department of Cardiology, University Medical Centre Groningen, University of Groningen, The Netherlands. t.jaarsma@thorax.umcg.nl
authors.forename: T
authors.initials: T
authors.lastname: Jaarsma
authors.forename: A
authors.initials: A
authors.lastname: Strömberg
authors.forename: S
authors.initials: S
authors.lastname: De Geest
authors.forename: B
authors.initials: B
authors.lastname: Fridlund
authors.forename: J
authors.initials: J
authors.lastname: Heikkila
authors.forename: J
authors.initials: J
authors.lastname: Mårtensson
authors.forename: P
authors.initials: P
authors.lastname: Moons
authors.forename: W
authors.initials: W
authors.lastname: Scholte op Reimer
authors.forename: K
authors.initials: K
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Stewart
authors.forename: D R
authors.initials: DR
authors.lastname: Thompson
mesh_terms: D000359:Aftercare / Q000458:organization & administration; D000553:Ambulatory Care / Q000458:organization & administration; D003191:Comprehensive Health Care / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003299:Cooperative Behavior; D019468:Disease Management; D005060:Europe; D005081:Exercise Therapy / Q000458:organization & administration; D005194:Family Practice / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration