title: [ANMCO/SIC Consensus document: The heart failure network: organization of outpatient care].
abstract: Changing demographics and an increasing burden of multiple chronic comorbidities in western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of-hospital phases of HF. The needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for hospitalized HF and those followed up at HF clinics.The Working Group on Heart Failure of the Italian Association of Hospital Cardiologists (ANMCO) has drafted a consensus document for the organization of a national HF care network. The aims of this document are to describe tasks and requirements of the different health system points of contact for HF patients, and to define how diagnosis, management and care processes should be documented and shared among healthcare professionals. In this document, HF clinics are classified into three groups: 1) community HF clinics, devoted to the management of stable patients in strict liaison with primary care, regular re-evaluation of emerging clinical needs and prompt treatment of impending destabilizations, 2) hospital HF clinics, that target both new-onset and chronic HF patients for diagnostic assessment, treatment planning and early post-discharge follow-up. They act as main referral for medicine units and community clinics; 3) advanced HF clinics, directed at patients with severe disease or persistent clinical instability, candidates to advanced treatment options such as heart transplant or mechanical circulatory support. These different types of HF clinics are integrated in a dedicated network for the management of HF patients on a regional basis, according to geographic features. By sharing predefined protocols and communication systems, these HF networks integrate multiprofessional providers to ensure continuity of care. This consensus document is expected to promote a more efficient organization of HF care, in particular for elderly patients and in transition phases from acute to chronic HF, by networking outpatient cardiology offer and primary care.
authors: U.O.C. Cardiologia-UTIC, Presidio Ospedaliero San Filippo Neri, Roma.
authors: Nadia
authors: N
authors: Aspromonte
authors: U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania.
authors: Michele Massimo
authors: MM
authors: Gulizia
authors: S.C. Centro Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste.
authors: Andrea
authors: A
authors: Di Lenarda
authors: U.O. Cardiologia Clinica e Scompenso Cardiaco, Policlinico di Monza, Monza.
authors: Andrea
authors: A
authors: Mortara
authors: S.O.D. Cardiologia Ospedaliera-UTIC, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona.
authors: Ilaria
authors: I
authors: Battistoni
authors: Istituto di Fisiologia Clinica del CNR, ASST Grande Ospedale Metropolitano Niguarda, Milano.
authors: Renata
authors: R
authors: De Maria
authors: U.O.C. Cardiologia, Ospedale Ajello c/o Ospedale Vittorio Emanuele I, Castelvetrano (TP).
authors: Michele
authors: M
authors: Gabriele
authors: U.O. Cardiologia Universitaria, Ospedale Policlinico, Bari.
authors: Massimo
authors: M
authors: Iacoviello
authors: U.O.C. Cardiologia, Ospedale Civile, Guastalla (RE).
authors: Alessandro
authors: A
authors: Navazio
authors: U.O. Cardiologia Clinica, Istituto Clinico Humanitas, Rozzano (MI).
authors: Daniela
authors: D
authors: Pini
authors: U.O. Cardiologia, Istituti Ospitalieri, Cremona.
authors: Giuseppe
authors: G
authors: Di Tano
authors: S.O.D. Cardiologia Ospedaliera-UTIC, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona.
authors: Marco
authors: M
authors: Marini
authors: U.O.C. Cardiologia-UTIC, Presidio Ospedaliero San Filippo Neri, Roma.
authors: Renato Pietro
authors: RP
authors: Ricci
authors: Unità Integrata Scompenso Cardiaco, Ospedale di Assisi, Assisi (PG).
authors: Gianfranco
authors: G
authors: Alunni
authors: S.C. Centro Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste.
authors: Donatella
authors: D
authors: Radini
authors: Cardiologia, Spedali Civili, Brescia.
authors: Marco
authors: M
authors: Metra
authors: U.O.C. Cardiologia e Cardiologia Interventistica, Policlinico "Tor Vergata", Roma.
authors: Francesco
authors: F
authors: Romeo
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D002309:Cardiology / Q000458:organization & administration*; D002908:Chronic Disease; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012955:Societies, Medical