Improving heart failure morbidity through individually tailored disease management

Abstract

HF is a complex clinical condition characterized by cardiac and non cardiac morbidity, with high morbidity and mortality and incremental costs for health care. The objective of this thesis was to investigate if optimal patient care through an individually tailored approach would lead to better outcomes. A first study was set up to assess the impact of RAS and ' blocker uptitration in HFrEF versus HFpEF patients after hospital admission; which concluded that uptitration of RAS blockers after a HF hospitalization is more feasible in younger patients with low co morbidity burden, and is an independent predictor of outcome in HFrEF but not HFpEF patients. Next to an optimal neurohumoral blocker therapy, elaborate HF care also comprises an extensive disease management program. A second study was set up to investigate the feasibility and impact of a hospital-wide, individually tailored and transmural disease management program in reducing ADHF and all-cause readmission rates and improving cl