The Canadian chronic heart failure clinics network

Abstract:

As in many countries, chronic heart failure (CHF) in Canada
affects >1% of the population, is responsible for 9% of all
deaths, and is the most common cause of hospitalization of
patients over 65 yrs. In some regions of Canada, the rate of CHF
is increasing as much as 4% annually. The Canadian Cardiovascular
Society published consensus guidelines for the diagnosis and
management of CHF in 1994 but treatments remain underutilized.
Newer treatments are introduced and proven beneficial with a
rapidity that exceeds the updating of national guidelines.
The Canadian CHF Clinics Network has been established to address
the health burden of CHF, to improve patient quality of life, to
enhance the translation of clinical trials into clinical
practice, to provide a model for outpatient management of CHF in
a physician-directed/nurse managed multidisciplinary paradigm,
and to improve the cost effectiveness of care. Eleven initial
centres have developed, by consensus, a manual of CHF management
for physicians, nurses, and patients, a national computerized
database to collect baseline and follow up data and outcomes, and
a strategy of education and preceptorships to enhance CHF
treatment in the community. The initial centres represent a
national cross section of academic and teaching hospital centres
with expertise in CHF management. The first patient was entered
into the Network database in January 1999 and up to 20 more
centres will be enrolled in the next 12 months. Baseline clinical
data will be analyzed and the data for the first 3 months will be
presented.
The Network will provide the basis to measure the impact and
outcomes of a structured CHF clinic in a wide diversity of
communities across Canada. Its database is flexible to allow new
modalities of treatment to be tested in a broad range of patients
normally seen in clinical practice. Improved implementation of
proven therapies combined with intensive patient education should
reduce hospitalizations and improve patient health.