Improving heart failure care through digital health education

Heart failure is a serious condition where the heart does not pump blood to the rest of the body as well as it should. Heart failure affects 480,000 Australians and is associated with high rates of hospital admissions. Regional and remote medical practices face particular challenges in their communities, including higher rates of cardiovascular disease compared to major cities.

Several practice gaps exist that may contribute to poor patient outcomes, including lack of recognition of the signs and symptoms of heart failure, as well as underdiagnosis and undertreatment.

The Heart Foundation is collaborating with NPS MedicineWise on a national program for primary care, based on Australian clinical guidelines for heart failure, to keep people with heart failure out of hospital and living better, longer lives.

The program addresses practice gaps and barriers through digital and face-to-face education for primary care health professionals, including access to digital resources for both health professionals and patients.

Virtual educational visits

Free virtual educational visits are being delivered by NPS MedicineWise to general practices across Australia, as part of the multifaceted program designed to:

• support general practitioners (GPs) with the early diagnosis of heart failure
• provide clinical guidance on prescribing heart failure medicines, including initiation and ongoing management
• empower people living with heart failure with effective self-management strategies to improve their quality of life.

The virtual educational visits are accredited as a continuing professional development activity by the Australian College of Rural and Remote Medicine and the Royal Australian College of General Practitioners. Visits are offered in-person and are taking place between March 2021 and February 2022. As of September 2021, just over 4000 visits have been completed, and around one-third of these have been delivered in regional or remote Australia, either virtually or in-person.

Digital education resources

As part of the program, a suite of digital health education resources has been developed for health professionals and patients. Early research as part of the program indicates that GPs in regional and remote practices are uncertain about starting and optimising heart failure medicines. To address this, a practical guide to up-titrating heart failure medicines and managing adverse effects was developed and is freely available digitally. Feedback from the educational visits shows GPs find this resource very useful.

Several practices commented on a common ‘she’ll be right’ attitude among regional Australians and many who ‘downplay their symptoms’, making investigating suspected heart failure challenging. The program aims to improve recognition of the signs and symptoms of heart failure through digital resources for patients, including the Living Well with Heart Failure video series, available in multiple languages, and practical tools like the patient action plans and fact sheets.

Digital delivery of cardiac rehabilitation

For people living with heart failure, attending a cardiac rehabilitation program reduces hospitalisations, supports long-term lifestyle changes and improves people’s quality of life. However, practices in regional and remote locations are challenged by poor access to these services. The most common barrier to cardiac rehabilitation attendance is proximity, with long distances to travel resulting in low participation rates. Digital health has increased the range of ways cardiac rehabilitation programs can be delivered, including via telehealth and home-based interventions. The Australian Cardiovascular Health and Rehabilitation Association and the Heart Foundation note in their position statement that telehealth complements face-to-face care and gives more people the opportunity to benefit from cardiac rehabilitation.

To find out where your local cardiac rehabilitation service is located, visit heartfoundation.org.au/cardiac-services-directory

To request a free educational visit go to Heart failure: an active role for GPs and patients.

For more information about the NPS MedicineWise heart failure program and to access the resources and tools, including on-demand webinars, visit the program website Heart failure: taking an active role.

The NPS MedicineWise heart failure program is funded by the Australian Government Department of Health.