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Heart failure programmes in countries with a primary care‐based health care system. Are additional trials necessary? Design of the DEAL‐HF study
Author(s) -
Porte Pieta W.F. BrugginkAndré,
Lok Dirk J.A.,
Wijngaarden Jan,
Cornel Jan H.,
PruijsersLamers Dian,
Veldhuisen Dirk J.,
Hoes Arno W.
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.11.004
Subject(s) - medicine , health care , intervention (counseling) , population , developed country , heart failure , intensive care medicine , family medicine , nursing , environmental health , economic growth , economics
Background Several randomised studies of heart failure (HF) management programmes in the United States, Australia and Europe have shown a considerable reduction in hospitalisation rates for HF. In this article, a comprehensive review of these studies will be provided and their applicability to countries, with a primary care‐based healthcare system, will be discussed. In addition, the design of the Deventer‐Alkmaar HF Project (DEAL‐HF), a randomised study of the effect of a nurse and physician‐directed intervention over 1 year in The Netherlands, will also be presented. Aim To discuss the applicability of the results of available studies on heart failure management programmes to countries with well‐structured primary care facilities and to determine whether additional trials should be conducted in these countries. Methods We performed a literature search in PubMed. In a review of the available studies, essential methodological aspects, in particular, the population involved, the sample size, follow‐up period, setting, type of intervention, and the outcome parameters, are discussed critically. Also, the applicability of these studies to countries with a primary care‐based healthcare system and easy access to medical care is evaluated. Conclusion Applicability of the results of the available studies on the efficacy of heart failure management programmes to countries with a primary care‐based health care system is doubtful. An efficacy trial in a country with a well‐established primary care‐based healthcare system, such as The Netherlands, is due to report soon (DEAL‐HF).