title: Chronic heart failure management in Australia -- time for general practice centred models of care?
abstract: BACKGROUND
  Chronic heart failure (CHF) is an increasingly prevalent problem within ageing populations and accounts for thousands of hospitalisations and deaths annually in Australia. Disease management programs for CHF (CHF-DMPs) aim to optimise care, with the predominant model being cardiologist led, hospital based multidisciplinary clinics with cardiac nurse outreach. However, findings from contemporary observational studies and clinical trials raise uncertainty around the effectiveness and sustainability of traditional CHF-DMPs in real-world clinical practice.
  
  
  OBJECTIVE
  To suggest an alternative model of care that involves general practitioners with a special interest in CHF liaising with, and being up-skilled by, specialists within community based, multidisciplinary general practice settings.
  
  
  CONCLUSIONS
  Preliminary data from trials evaluating primary care based CHF-DMPs are encouraging, and further studies are underway comparing this model of care with traditional hospital based, specialist led CHF-DMPs. Results of studies of similar primary care models targeting diabetes and other chronic diseases suggest potential for its application to CHF.
authors.affiliation: Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia. ian_scott@health.qld.gov.au
authors.forename: Ian
authors.initials: I
authors.lastname: Scott
authors.forename: Claire
authors.initials: C
authors.lastname: Jackson
mesh_terms: D001315:Australia; D019468:Disease Management; D058006:General Practice / Q000458:organization & administration*; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D017146:Models, Organizational