Clinical Heart fAilure Management Program: Changing the practice by partnering primary care and specialists (CHAMP-HF)

• Published in: International journal of cardiology. Heart & vasculature 2024-02, Vol.50, p.101330, Article 101330
• Main Authors: Parent, Marianne, Leclerc, Jacinthe, O'Meara, Eileen, Barrette, Réal, Lévesque, Sylvie, Parent, Marie-Claude, Brouillette, Denis, Garceau, Patrick, Liszkowski, Mark, Rouleau, Jean, Ducharme, Anique
• Format: Article
• Language: English
• Subjects: Collaboration; Diagnostic; Disease awareness; Education; Heart failure; Management; Original Paper
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2023.101330

•Most heart failure patients are diagnosed late in the course of their disease, in hospital with acute decompensation, while as many as 50 % of these patients have had symptoms for up to 5 years. This may explain the high and unchanged mortality rate of 50 %, 5 years after a diagnosis of HF.•This delay in proper HF diagnosis may lead to poor quality of life and decreased survival, that could potentially be alleviated if diagnosed early and treated appropriately.•It is common belief that the majority of heart failure patients are followed in the community by primary care providers. However, each family practitioner follows individually only a handful of patients, representing less than 1% of their caseload, which make difficult to have a high index of suspicion to diagnose heart failure early.•When a specialized heart failure academic team partners with a family practice group in an educational program, it empowers the primary care to diagnose heart failure and improve its management. While significant gains were made in the management of heart failure (HF), most patients are still diagnosed when they are acutely ill in hospital, often with advanced disease. Earlier diagnosis in the community could lead to improved outcomes. Whether a partnership and an educational program for primary care providers (PCP) increase HF awareness and management is unknown. We conducted an observational study between March 2019 and June 2020 during which HF specialists gave monthly HF conferences to PCP. Using a pre-post design, medical charts and administrative databases were reviewed and a questionnaire was completed by participating PCP. Primary and secondary endpoints included: 1) the number of patients diagnosed with HF, 2) implementation of GDMT for patients with HFrEF; 3) PCPs’ experience and confidence. Six PCP agreed to participate. Amongst the 11,909 patients of the clinic, 70 (0.59 %) patients met the criteria for HF. This number increased by 28.6 % (n = 90) after intervention. Increased use of GDMT for HFrEF patients at baseline (n = 35) was observed for all class of agents, with doubling of patients on triple therapies, from 8 (22.9 %) to 16 (45.7 %), p = 0.0047. Self-confidence on HF management was low (1, 16.7 %) but increased after the educational intervention of physicians (3, 50 %). An educational and collaborative approach between HF specialists and community PCP increased the number of new HF cases diagnosed, enhanced implementation of GDMT in patients with