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Caldeira D, Brito D, Aguiar C, Silva Cardoso J, Fonseca C, Franco F, Macedo F, Moura B, Pinto FJ, Vaz-Carneiro A. Expert perspectives on strategic factors for the management and prevention of heart failure in Portugal. Rev Port Cardiol 2023; 42:885-891. [PMID: 37257583 DOI: 10.1016/j.repc.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Heart failure (HF) has significant morbidity and mortality, and its prevalence will continue to increase in the future. This unfavorable evolution requires reflection as well as recommendations and decisions based on expert critical and strategic appraisal. METHODS In the Acceleration on Heart Failure Empowerment and Awareness - the Portuguese Challenge (ATHENA-PT) study, a range of strategic factors that represent the strengths, weaknesses, threats, and opportunities (SWOT) of HF in Portugal were established. These factors were assessed quantitatively by experts, to create a final SWOT matrix for the management and prevention of HF in Portugal and to outline recommendations. RESULTS For HF management, the panel emphasized the following strategic recommendations: (i) reimbursement of natriuretic peptides testing in primary healthcare; (ii) reimbursement of Doppler assessment in echocardiographic studies and promotion of detailed information in reports; (iii) intervention to improve the prognosis of patients with HF with preserved ejection fraction; (iv) ensuring effective healthcare transition between hospital and ambulatory units, using checklists/protocols; and (v) reinforcement and commitment to the training of primary health physicians and to the cardiac rehabilitation of patients. For the prevention of HF, the following recommendations/proposals were proposed: (i) campaigns to raise awareness of cardiovascular disease risk factors; (ii) promotion of physical exercise and healthy eating; and (iii) avoidance of therapeutic inertia in the management of risk factors. CONCLUSIONS The acknowledgment of various strategic factors and their prioritization by experts made it possible to create and reinforce a range of new strategic recommendations for the management and prevention of HF.
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Affiliation(s)
- Daniel Caldeira
- Serviço de Cardiologia, Hospital Universitário de Santa Maria - CHULN, Portugal; Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Laboratory of Clinical Pharmacology and Therapeutics and Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina da Universidade de Lisboa, Portugal.
| | - Dulce Brito
- Serviço de Cardiologia, Hospital Universitário de Santa Maria - CHULN, Portugal; Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Carlos Aguiar
- Unidade de Insuficiência Cardíaca Avançada, Serviço de Cardiologia, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Portugal
| | - José Silva Cardoso
- Faculdade de Medicina, Universidade do Porto, Oporto, Portugal; Department of Cardiology, Centro Hospitalar Universitário de São João, Oporto, Portugal; CINTESIS, Center for Health Technology and Services Research, Faculdade de Medicina, Universidade do Porto, Oporto, Portugal
| | - Cândida Fonseca
- Serviço de Medicina/Clínica de Insuficiência Cardíaca, Hospital de S. Francisco Xavier, CHLO, Portugal; Hospital da Luz Lisboa e NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal
| | - Fátima Franco
- Unidade Tratamento IC Avançada (UTICA), Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Filipe Macedo
- Centro Hospitalar de São João, Serviço de Cardiologia, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Portugal
| | - Brenda Moura
- Faculdade de Medicina da Universidade do Porto, Portugal; Hospital das Forças Armadas - Pólo do Porto, Portugal
| | - Fausto J Pinto
- Serviço de Cardiologia, Hospital Universitário de Santa Maria - CHULN, Portugal; Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - António Vaz-Carneiro
- Instituto de Saúde Baseada na Evidência (ISBE), Faculdade de Medicina da Universidade de Lisboa, Portugal
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