Heart failure registry, chronic care model can help ease burden of cardiovascular disease

WHILE February is known as a time for love and romance, Filipino cardiologists on Feb. 15 shined the light on matters of the heart of a different kind: heart health, specifically heart failure.  

“Nearly a third of patients with heart failure have high risk of hospitalization or cardiovascular death, including those who appear stable,” said Lotis Ramin, country director of AstraZeneca Philippines, which is working with the Heart Failure Society of the Philippines (HFSP) on health programs that will raise awareness of heart disease.  

“Unfortunately, it’s not getting as much attention as it should,” she said at the briefing.  

Heart failure, defined as a condition where the heart can’t pump enough blood to fulfill the body’s needs, includes symptoms like shortness of breath and easy fatigability.������

The Philippine Statistics Authority found that was the top cause of mortality across the country, accounting for 17.9% of total deaths from January to November 2021. Two major risk factors of the disease, diabetes and hypertension, were also among the leading causes of death.������ 

“Seventy-four percent of heart failure patients suffer from at least one comorbidity that is more likely to worsen the patient’s overall health status,” said Dr. Chito C. Permejo, a fellow of the Philippine College of Cardiology.  

With hospitalization driving the cost of heart failure, the key to lessening its burden on the country would be a change in the care model, which would require collaboration to back the implementation of health policies.  

“We need to move towards the chronic care model, with multidisciplinary integrated care and patients stratified by need, with more complex patients being ‘case managed,’” he said.  

CAPACITY BUILDING
Dr. Liberty O. Yaneza, head of the heart failure section at the Philippine Heart Center, said that research assistance, education, manpower, and clinics across the country will need beefing up.  

She pointed out that the majority of heart failure clinics are in Metro Manila, with only a few advanced specialists in the Philippines catering to a large population of patients.  

“The plan [to set up more clinics] is already there; it’s just due for implementation,” she shared, referring to delays in capacity building due to the pandemic. “Later on, we need to emphasize that this should be seen as a multidisciplinary entity, not only cardiology.”  

The National Heart Failure Network — an alliance of stakeholders including the HFSP, the Philippine Heart Association, and other regional medical groups — aims to ease the burden of heart failure in the country.  

A registry can help this network as well as the government to be better equipped for the challenge, according to cardiologist Dr. Michael-Joseph F. Agbayani of the University of the Philippines College of Medicine.  

“The registry is a database that collects information that can be used to answer clinical questions and measure quality of care,” he said. “We can use it to generate studies about heart failure in the local setting.”  

For now, the one thing standing in the way of this database being built is funding, which has been difficult to come by due in large part to the pandemic.  

Dr. Permejo noted that the bulk of what can be done now is information dissemination.  

“We must educate people to look into their own profile, family history, and lifestyle. All of these taken together can create cardiovascular disease,” he said. — Brontë H. Lacsamana