Improvement of HF: initiative to increase awareness and improve the management of patients with heart failure in Europe

Heart failure is a major healthcare problem, with possibly over 10 million patients in Europe suffering from the syndrome. Its prevalence is increasing partly because the proportion of elderly population is likewise increasing. The guidelines on the diagnosis and treatment of heart failure have been published by the European Society of Cardiology and represent a landmark for judging current medical practice. Evidence suggests that heart failure is frequently underdiagnosed and undertreated, and the majority of patients may not be receiving appropriate care. Both primary healthcare physicians and hospital cardiologists are responsible for proper diagnosis and appropriate treatment of patients with heart failure. The "Improvement of HF" initiative has been developed by an International Advisory Board to increase awareness and improve the management of heart failure among primary healthcare physicians in Europe. The study first investigates how primary healthcare physicians perceive heart failure should be diagnosed and treated, and examines the availability of required resources. Subsequently, primary healthcare physicians will be interviewed to assess their actual practice by reviewing relevant case notes, covering diagnosis and treatment. The program will consist of a research phase and an educational phase. For the research phase, 10 regional centers (including both urban and rural areas) in each of the 14 participating countries in Europe will be identified, with each center randomly selecting 10 primary healthcare physicians. Each physician will supply case notes of 9 of his/her patients with diagnosed heart failure or at high risk of having heart failure. The results of the survey would identify any need to change not only perceptions but clinical practice in the diagnosis and treatment of heart failure and will be used to organize an educational program. A further study is planned in order to assess the impact of the initiative.