Disease Management of Chronic Heart Failure in the Elderly: Issues and Options
There is now conclusive evidence to support the widely prescribed application of disease management programs in heart failure care. These strategies result in significant improvement in many barometers of care, including admission rates, prescription of disease modifying therapy, and improved patient understanding and involvement in self care. Of particular importance in the future will be research designed to address the personnel requirements of disease management programs, the ideal format of the program, and how best to fit the program to a particular patient's needs. It is also likely that further development of these programs will result in the application of disease management programs to a wider group of the heart failure population, not simply focusing on patients with relatively severe disease, but also addressing and involving patients from the time of diagnosis, and possibly even targeting those at risk for the development of heart failure. It is by this more inclusive approach that the concept will work towards the accepted definition of a disease management program, which should include attention to the entire spectrum of the disease, and involve all aspects of the healthcare delivery system.
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