Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Heart failure

Optimal postdischarge management of chronic HF

Not all strategies for the management of chronic heart failure have been shown to be equally effective in improving outcomes, and the ideal programme has yet to be defined. The WHICH? trial sheds some light on whether a clinical, in-hospital or a home-based strategy of care is superior and cost-effective.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Kannel, W. B. Incidence and epidemiology of heart failure. Heart Fail. Rev. 5, 167–173 (2000).

    Article  CAS  Google Scholar 

  2. McAlister, F. A., Stewart, S., Ferrua, S. & McMurray, J. J. J. V. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J. Am. Coll. Cardiol. 44, 810–819 (2004).

    PubMed  Google Scholar 

  3. Dickstein, K. et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology: developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur. J. Heart Fail. 10, 933–989 (2008).

    Article  Google Scholar 

  4. Jessup, M. et al. 2009 focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119, 1977–2016 (2009).

    Article  Google Scholar 

  5. Stewart, S. et al. Impact of home versus clinic-based management of chronic heart failure: the WHICH? (Which Heart Failure Intervention Is Most Cost-Effective & Consumer Friendly in Reducing Hospital Care) multicenter, randomized trial. J. Am. Coll. Cardiol. 60, 1239–1248 (2012).

    Article  Google Scholar 

  6. Inglis, S. C., Clark, R. A., McAlister, F. A., Stewart, S. & Cleland, J. G. Which components of heart failure programmes are effective? A systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: abridged Cochrane Review. Eur. J. Heart Fail. 13, 1028–1040 (2011).

    Article  Google Scholar 

  7. Giordano, A., Zanelli, E. & Scalvini, S. Home-based telemanagement in chronic heart failure: an 8-year single-site experience. J. Telemed. Telecare 17, 382–386 (2011).

    Article  Google Scholar 

  8. Cawley, J. & Grantham, C. C. Building a system of care: integration across the heart failure care continuum. Perm. J. 15, 37–42 (2011).

    Article  Google Scholar 

  9. Wootton, R. Twenty years of telemedicine in chronic disease management—an evidence synthesis. J. Telemed. Telecare 18, 211–220 (2012).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Simonetta Scalvini.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scalvini, S., Giordano, A. Optimal postdischarge management of chronic HF. Nat Rev Cardiol 10, 9–10 (2013). https://doi.org/10.1038/nrcardio.2012.161

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2012.161

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing