Australia in Midst of Heart Failure Epidemic

By Petrina Smith
Thursday, 19 June, 2014

heart failureResearchers at Baker IDI Heart and Diabetes Institute have warned that Australia is in the midst of a heart failure epidemic that continues to grow, with one in 20 Australians affected by the condition.
Unveiling the latest national data, the researchers said the number of Australians affected by Heart Failure has risen from 350,000 people in 2002 to 500,000 people more than a decade later. 
Professor Simon Stewart, Head of Preventative Health at Baker IDI said a national response was needed in order to address this enormous health problem.In 2012/13 alone, heart failure is estimated to have contributed to over 650,000 days of hospitalisation at a cost of more than $1 billion ($300 million per annum alone for new cases of Heart Failure).
"One of the reasons this is so insidious is that heart failure is not well understood and around half of people who have a latent form of chronic heart failure will experience no direct symptoms until they require an emergency hospital admission. Heart failure is commonly mistaken to mean ‘heart attack'. But heart failure is actually a chronic and debilitating condition more like a syndrome and is characterised by permanent damage to the heart with detrimental consequences for vital organs such as the kidneys and brain.
"There are varying degrees of heart failure severity, but as a general rule, people with heart failure often experience shortness of breath, fatigue and an inability to sleep. People can be diagnosed with heart failure prior to, or following, a catastrophic event such as a heart attack, and having heart failure puts people at much greater risk of such an event," said Professor Stewart.
For those living with chronic heart failure, the risk of poor quality of life, recurrent hospitalisation and a premature death is high. The five year prognosis for patients diagnosed with heart failure is often worse than most common cancers, including breast cancer in women. Once hospitalised with heart failure, there is a high risk of a ‘downward spiral' of multiple re-admissions and a premature death.
Overall, we estimate close to 10,000 women and an equal number of men (close to 20,000 people in total) were diagnosed with heart failure following their first hospital admission with the condition in the last 12 months; with many more people in the community unaware they have the condition. Men are more likely to develop heart failure earlier in life due to a heart attack or a ‘near miss' while women are more susceptible later in life as a result of chronically high blood pressure.
The data shows that people in NSW are just as likely to experience heart failure as people in Tasmania and most other states. Alternatively, we know that the Indigenous peoples of Central Australia have almost twice the risk of developing the syndrome (with more women and younger people affected). Reflecting variations in state population figures, 309,721 people in NSW were diagnosed with heart failure, compared with 233,172 in Victoria and 5,244 in the Northern Territory.
"In light of these figures, it is clear that Australia urgently needs a national strategic plan to address the complex issues arising from this ‘hidden epidemic'. As part of that plan, we need to be looking at comprehensive prevention strategies such as cost-effective screening programs, supported by awareness campaigns targeting both the public and health care professionals.
"The findings also highlight significant scope to re-examine the way we manage and treat people with heart failure. In many developed countries, we're seeing the implementation of multidisciplinary post-discharge care programs, with a major role for specialist heart failure nurses. These programs have been proven to be cost-effective with an added incentive that they reduce hospital admissions and associated costs."
There is now significant evidence to show that dedicated nurse-led programs (delivered in the home and supplemented by follow-up telephone calls) can reduce hospital re-admissions and prolong survival in those hospitalised with heart failure.
In partnership with major hospitals and the National Heart Foundation of Australia, Professor Stewart and his team have established a network of nurses to determine if they can further improve health outcomes for affected patients across Australia (including those living in regional/rural Australia) as part of an NHMRC-funded trial.
Under the trial, hospital-based nurses visit patients in their home following an admission to hospital with heart failure. The nurses assess patient needs according to a unique traffic light protocol to determine how best to support the patient and their families to cope with this disabling and deadly condition.
The program is supported by a team of nurses, known as the "GARDIAN Angels" at the Heart Foundation's National Call Centre in Adelaide who use the system to monitor patients and their families via the telephone. Early indications from the trial have been overwhelmingly positive, with a reduction in hospital re-admissions and better overall health outcomes.

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