Editorial
The Need for Heart Failure Advocacy in Canada

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Impact of HF on Patients and Health System Outcomes

HF currently affects 600,000 Canadians and is a leading cause of hospitalization, which is a major driver of the $2.8 billion dollars per year in direct health care costs spent on this disease.4 Despite major advances in diagnosis and treatment, Canadians hospitalized with HF have readmission rates in excess of 20% at 30 days and mortality rates upward of 30% at 1 year. These statistics have not improved over the past decade and are expected to rise as the population ages.1

On admission to the

Building a System of Care for Patients With HF

Multiple studies and meta-analyses have shown that disease management interventions that focus on patient empowerment, education, careful clinical follow-up, and pharmacologic/device optimization are associated with decreased hospital admission and health care use as well as improved quality of life and survival.8 Furthermore, integration of primary and specialty care services in the management of these complex patients is associated with improved outcomes.9

In reality, however, the actual

Quality Improvement With Quality Data: The Case for a National HF Registry

The provision of quality care must be a goal of any health care system designed to achieve optimal outcomes. Performance indicators, such as those developed by the CCS Quality Project,16 allow us to track our collective adherence to the delivery of quality HF care nationally; however, for this process to work, a data backbone must be present to enable measurement.

A plethora of data systems exist in Canada to describe inpatient outcomes and quality of care. In many jurisdictions, these efforts

Improved Outcomes Require Timely Access to Treatment

Over the past decade, the CCS HF guidelines have provided clinicians with up to date evidence-based treatment algorithms for the management of HF.8 Unfortunately, in some instances, HF therapies have not been made available to Canadians in a timely manner. For example, there was a 7-year delay between publication of the landmark Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT) trial19 and Health Canada's approval of ivabradine for the treatment of HF. Meanwhile,

The Patient Voice in HF Treatment, Research, and Advocacy

Patients' active participation in their own treatment is critical to the success of any medical intervention designed to improve quality of life. Engaging patients as partners in their own care is especially important for those with HF, given the disease complexity, the high frequency of comorbidities, and the severe strain the disease places on patients and their families. HF self-management is key to improving patient outcomes.22

Not infrequently, patients receive discordant recommendations

Driving Change Through Collaboration: A Call to Action

Harnessing the growing momentum in HF advocacy to improve outcomes for those with this disease will require a comprehensive Canadian HF action plan built on strong stakeholder collaboration. It will require an alliance of organizations to mobilize resources and work together at regional, provincial, and national levels. These partners must include patient advocates such as HeartLife Foundation, professional associations, health systems administrators and policy makers, the Heart and Stroke

Disclosures

Dr Virani discloses the following conflicts of interest: Consulting fees and honoraria: AstraZeneca, Bayer, Boehringer Ingelheim, Medtronic, Novartis, Novo Nordisk, Otsuka, Pfizer, Servier, Takeda; Clinical trials and research grants: Bayer, Medtronic, Merck, Novartis, Otsuka, Pfizer, Servier. Dr Ducharme discloses the following conflicts of interest: Speakers bureau: Abbott, Novartis, Rocher, Servier; Research grants: Abbott, Edwards Medical, Novartis. Dr Howlett discloses the following

References (22)

  • L.C. Doherty et al.

    Carer's needs in advanced heart failure. A systemic narrative review

    Eur J Cardiovasc Nurs

    (2016)
  • Cited by (20)

    • Evidence-Based Management of Acute Heart Failure

      2021, Canadian Journal of Cardiology
      Citation Excerpt :

      Within Canada, there are an estimated 600,000 patients with HF and it accounted for $2.8 billion Canadian Dealing Network (CDN) in health care costs in 2016.4 It is expected that the prevalence and costs for HF will continue to rise.5 Similarly, in the United States, the estimated cost of HF was $30.7 billion in 2012, and this cost is predicted to exponentially rise to $160 billion by 2030.6

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