title: Specialist heart failure clinics must evolve to stay relevant.
abstract: The widespread acceptance of heart-failure (HF) clinics is based on studies with poor and poorly-described care. This led to HF-clinic proliferation, often with access for a small percentage of younger, healthier and generally affluent patients. This system fails to provide the essential timely access to specialist-team consultation following hospital-discharge. Recent well-conducted randomized trials of HF-clinic care found no benefit over usual care. To provide optimal value, HF-clinics must evolve to devote resources to timely assessment/reassessment and close follow-up of selected high-risk/advanced HF patients, along with timely support of the primary-care team that will assure the bulk of routine HF care.
authors.affiliation: Department of Cardiac Sciences, University of Calgary and Libin Cardiovascular Institute, Calgary, Alberta, Canada. Electronic address: howlettjonathan@gmail.com.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Howlett
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D010348:Patient Care Team / Q000592:standards*; D013038:Specialization