The Wider Considerations in Closing Chronic Disease Gaps – Focus on Heart Failure and Implementation

Title:The Wider Considerations in Closing Chronic Disease Gaps – Focus on Heart Failure and Implementation

Volume: 19 Issue: 2

Author(s): Pupalan Iyngkaran*, Charlotte Hespe, Fahad Hanna, John D Horowitz, Malcolm Battersby, Craig Nelson, Sharon Andrew and Maximilian P. de Courten

Affiliation:

• Heart Failure & Cardiac Imaging, University of Notre Dame, Werribee Mercy Sub School, School of Medicine Sydney; Research Fellow Mitchell Institute, Victoria University, Victoria, Australia

Keywords: Chronic disease, clinical translation, Heart failure, health policy, screening, patient reported outcomes

Abstract:

Background: Heart failure (HF) is predominately a chronic disease. There are overlaps in HF and chronic disease research and care. Chronic disease and HF research are conducted with multiple goals. The overarching goal is “optimized patient outcomes at maximum costeffectiveness”. However, observations on patients can come with many variables; thus, we see differences in clinical translation. This document discusses an argument for three important gaps common to HF and chronic disease, i.e., screening, self-management, and patient-reported outcomes (PRO), and provides a glance of how it could fit into the evidence tree. Pertinent arguments for a framework for health services and models of care are provided as a prelude to future consensus.

Methodology: 1) A preliminary literature review to identify a taxonomy for cardiovascular research, and 2) a review of the published literature describing the translation of research studies into clinical practice for cardiovascular disorders. A spectrum from observational to large randomized controlled trials to post-marketing studies were identified.

Discussion: A brief discussion on traditional research and differences focusing on screening, mixed methods research concepts, and chronic diseases models of care. Six steps to facilitate this: 1) Research design; 2) Research application (translation) i. routine ii. challenges; 3. Transforming research to translational level; 4. Funding and infrastructure; 5. Clinical Centres of Research Excellence (CCRE) and collaboration; 6. Governance and cost-effectiveness.

Conclusion: Implementation research that aims to link research findings to improved patient outcomes in an efficient and effective way is a neglected area. Skills required to perform implementation research are complex. Ways to maximize translational impacts for chronic disease research to clinical practice are described in a HF context.

Cite this article as:

Iyngkaran Pupalan*, Hespe Charlotte, Hanna Fahad, Horowitz D John, Battersby Malcolm, Nelson Craig, Andrew Sharon and de Courten P. Maximilian, The Wider Considerations in Closing Chronic Disease Gaps – Focus on Heart Failure and Implementation, Current Cardiology Reviews 2023; 19 (2) : e120522204690 . https://dx.doi.org/10.2174/1573403X18666220512160737