Addressing heart failure

Heart failure is a common, costly and severe condition that carries a risk of premature death that is higher than that for most types of cancer, including breast and prostate. More than 37.7 million people are estimated to be affected globally; about 900,000 people are in the United Kingdom, and more than half of them are over the age of 75.

Many heart failure patients experience poor quality of life, with symptoms of swollen ankles, tiredness, and shortness of breath, and are commonly readmitted to hospital owing to fragmented and frequently inadequate care in the community.

A research team at The George Institute is seeking to redress gaps in heart failure policy and practice. SUPPORT-HF, a recently completed trial funded by the National Institute of Health Research, tested a tool for monitoring and managing heart failure and medications at home through a tablet PC, blood pressure cuff and weighing scales. By embedding community care into a wider system of quality preventative and primary treatment, patients and carers were able to gain greater control of their health outcomes, while assisting healthcare professionals to more effectively support them over the long-term.

Patients involved in SUPPORT-HF generally used the system daily by answering a few questions about their symptoms, and recording measures of their blood pressure and weight. These records were visible to the patient and all stakeholders caring for them. Patients were also able to access information about their condition, treatments, and advice on staying healthy.

High-impact findings from this trial confirmed the benefit of thinking innovatively about healthcare delivery, particularly facilitating user-centred home monitoring that was both acceptable and widely used by patients. The tool is now being rolled out in light of the improved patient outcomes and its contribution to relevant public health policy.

Despite recent policy commitments to strengthen the identification, care and management of chronic heart failure in the UK, significant disparities exist in the quality and nature of care received, with women, older people and deprived populations particularly prone to receiving sub-optimal care. Our researchers are trying to understand these disparities by recognising the patient journey as a care continuum (across healthcare settings and providers), to provide evidence-based policy recommendations and practice guidance.