Life-saving new service for patients with heart failure
A new approach to heart failure treatment is giving patients a better quality of life and reducing their risk of being readmitted to hospital.
Heart failure (HF) is a serious condition that affects millions of people around the world, and finding ways to improve treatment and outcomes is crucial.
The STRONG-HF trial highlighted a critical difference between the standard treatment, involving a slower approach of administering medication versus a rapid initiation and gradual adjustment of medication.
Patients who received rapid initiation of HF medication not only experienced fewer symptoms and improved quality of life but also had a remarkable 33% lower risk of death or hospitalisation over six months compared to those receiving the standard approach. One of the key reasons for this success was the speed at which medications were adjusted, six weeks versus six months – which is how long it usually takes for patients to reach the target doses of all four essential HF drugs.
Based on these findings our new Heart Failure Rapid Titration Service set up at Barts Health aims to address this need by revolutionising the way we manage and treat patients with heart failure.
Consultant cardiologist, Dr Christopher Primus, explains: “Heart failure is a condition that requires prompt and effective management, and delays can have serious consequences. Our new service addresses the gaps in traditional care models by offering a faster, more efficient approach that aligns with the latest clinical evidence. As we continue to refine and expand this service, we are confident it will lead to better outcomes for patients and help reduce the strain on healthcare resources.”
The heart failure team at Whipps Cross has already implemented a virtual version of this service using the Ortus platform that helps to monitor patients remotely with care teams reviewing the information and making some of the clinical or prescribing decisions remotely. The initial results, presented at the European Society of Cardiology Heart Failure World Congress 2024, have been highly encouraging with patients reaching their target dose in 36 days with no adverse effects reported.
A total of 96 patients have now taken part in the programme across Barts Health and UCLH, with 43 managed on the platform and 53 discharged to their usual treating team. On average, patients saw a significant reduction in markers that indicate heart failure from admission to discharge, while their heart function (LVEF) improved by 19%. Remarkably, none of the patients were readmitted due to heart failure. Nearly all (92%) were discharged on all four key heart failure treatments. Every patient reported being satisfied with their care. With drugs collectable from local pharmacies we have also saved over two hours of travel time and cost in 40% of patients, and an estimated 1.6 tonnes of CO2 saved by avoiding couriers to deliver drugs.
A patient commented: “Excellent service provided, very fast enrolment. My breathing is better than it has been for years. Thank you!”
This rapid scaling means we can transform how heart failure patients are treated across the Trust. By prioritising faster treatment, reducing unnecessary tests and in-person appointments, and streamlining decision-making, the service will make a significant difference to the lives of patients with heart failure.
We’re pleased to accept referrals from the Heart Failure teams at Barts Health. Please contact us at bartshealth.heartfailuretitration@nhs.net.
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