Programas de intervención en la insuficiencia cardiaca: análisis crítico

The prognosis of chronic heart failure continues to be poor despite recent advances in therapy. One of the main reasons for the limited improvement in prognosis is the failure to use treatment effectively, partly because of the magnitude of the problem of chronic heart failure and partly because treatment can be complex. Disease management and patient education programs have been shown to improve both treatment quality and prognosis in patients with chronic heart failure, thereby reducing the hospital admission rate and improving survival. Nevertheless, there continue to be doubts about the economic impact and the cost-benefit ratio of such programs, as well as about their applicability to all patients with heart failure irrespective of age, associated comorbid condition, or type of left ventricular dysfunction. This article contains a discussion of all these topics, with a focus on research carried out in Spain.