Healthcare managers are more and more interested in the role of general practitioners (GP) in the
treatment of cardiovascular diseases. Continuing adjustments of the health organization are the
old/new challenge in improving patient care. The European Society of Cardiology guidelines recommend
a disease-management program for heart failure (HF); moreover, observational studies and
randomized controlled trials have reported better patient outcomes if patients are in charge of cardiologists
rather than GPs or other physicians.
Patients with chronic HF are often very old and affected by multiple comorbid conditions, by
themselves associated with high rates of morbidity and mortality. Furthermore, too many patients receive
neither a correct diagnosis nor treatment until advanced disease occurs. New treatment approaches,
some of them requiring the expertise of well-trained cardiologists, are ongoing to improve
the clinical outcomes.
The optimal management of patients with HF needs teamwork, i.e. GPs, cardiologists, nurses and
caregivers, since a multidisciplinary program, only, can embody the best answer for outpatients with
chronic HF.
Currently, the Cardiovascular Center in Trieste is performing an experimental trial, so far never
attempted before, in treating patients with chronic HF using a thorough approach with the full involvement
of local cardiologists, GPs and nurses. Such approach is, at the same time, as well a challenge
as an opportunity: a challenge because conventional clinical habits must be changed; an opportunity
because patients can benefit from a proper whole care-group, aimed at prolonging life and
reducing morbidity and symptoms.
