Chronic Heart Failure
Chronic heart failure (CHF) is a complex clinical syndrome caused by structural or functional abnormalities in the heart which result in shortness of breath, fatigue, and oedema. It is a severe, disabling condition, which negatively impacts on quality of life. CHF affects an estimated one million people in Australia, a third of which reside in NSW. Incidence of CHF increases with age and is commonly co-morbid with other conditions including atrial fibrillation, diabetes and kidney disease. The two leading causes of CHF, ischaemic heart disease and hypertension, are potentially preventable. However, prevalence remains high and it is one of the leading causes of admission and readmission to hospital. There are a total of 69 hospitals in NSW that admit 50 or more people with CHF per year.
In 2014-15, there were 15,000 separations for CHF in NSW, costing a total of $106 million. Across Australia, the number of admissions for CHF was 7.3 times higher in the highest area compared to the area with the lowest rate. Effective management of heart failure is well understood. It is involves multidisciplinary coordination of care across acute and primary care providers in order to support self-management and prevent acute episodes. Principles of best practice include compliance with optimal pharmacotherapy, surgical procedures and supportive devices, as well as a range of non-pharmacological interventions, community heart failure management programs and supportive end of life care.
Best practice guidelines for the prevention, detection and management of CHF were developed by the National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand in 2011. In addition, the ACI Cardiac Network published the NSW Clinical service framework for chronic heart failure in 2016, which provides best practice guidance for CHF across nine key standards. As with COPD, these guidelines can be used to provide a benchmark for optimal care delivery, reduce unwarranted clinical variation and improve outcomes for people with CHF across NSW.