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= Paid-up subscribersImproving the management of chronic heart failure
24 Nov 2010
NICE has updated its guideline on the management of chronic heart failure. The principal changes from the 2003 guideline include more directive advice on how to improve the quality and timeliness of diagnosis. There is greater encouragement to use beta-blockers, more emphasis on rehabilitation and better access to specialist advice - particularly at the time of diagnosis, admission to hospital, and where symptoms do not respond to first-line therapy with diuretics, ACE inhibitors and beta-blockers. 'A new recommendation is that patients with stable heart failure should be offered a supervised group exercise-based rehabilitation programme designed for such patients. This should include a psychological and educational component, and could be incorporated within an existing cardiac rehabilitation programme. This recommendation is likely to be picked up in the, as yet unpublished, ‘Commissioning Pack' for Cardiac Rehabilitation, and will lead to pressure locally on services to include heart failure patients. It is helpful that NHS Improvement has identified both heart failure and cardiac rehabilitation as priorities for 2010/11, but ultimately much of the responsibility for commissioning this new service will fall to primary care.'
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