How to Implement Recommendations on Multidisciplinary Heart Failure Management Program into Practice? Lithuanian Experience

Despite clear guideline recommendation to involve heart failure (HF) patients into multidisciplinary programmes (MP), availability of this specialized care remains insufficient throughout European countries. The aim of this study is to analyse the process of establishment, implementation metrics, and quality indicators (QIs) of heart failure multidisciplinary programme (HF-MP) in Lithuania. We conducted a retrospective analysis of the requisites, steps of initiation and development of HF-MP as a national service reimbursed since 2016. HF-MP is structured as 4 encounters with a specialized HF team during 1 year after HF decompensation. Based on the National Health Insurance Fund (NHIF) administrative data we present the effect of HF-MP intervention on cardiovascular readmissions, survival, and ICD implantations from 2018 to 2022. Aggregated 2018 to 2022 data from the NHIF showed that the odds for 1-year survival were 2.4 to 2.9 times higher in HF-MP cohort compared to usual care (UC), while the chances to survive without readmissions were 1.3 to 1.7 times greater than with UC. Health-related quality of life, index of self-care, and 6-min walk test had improved significantly at the last visit of HF-MP service (p < 0.001). In conclusion, sharing practical experience from HF clinics in Sweden and HF recommendations help to transfer HF multidisciplinary programmes to the national Lithuanian context. The effects of the intervention include reduction of morbidity and early mortality as well as improvement of quality of life of patients with heart failure.