1. Management of Co morbidities and Heart Failure in Primary Health Care (PHC) in Greece
T.Vasilopoulos1, C.Tatsi1, C. Lionis1
1Clinic of Social and Family Medicine, School of Medicine, University of Crete
Contact information: Clinic of Social and Family Medicine, School of Medicine of
University of Crete
P.O. Box: 2208, Heraklion, Crete, Greece
Website:
Phone:

2. The most common comorbidities of HF are:1
Rationale and Aim
It is very common, for Primary Health Care (PHC) professionals, to manage and monitor patients with Heart Failure (HF) and comorbidities, always in collaboration with the cardiologist(s) or/and hospital.
Research Question: Which interventions according to the literature are cost effectiveness in order to manage and monitor patients with HF and comorbidities in PHC in Greece?
The aim of our study is to identify which are the appropriate ways to monitor and manage patients with HF and comorbidities in PHC, in order to reduce the expenses of hospitalization and to provide high quality health care services to those patients who live in rural areas.
The most common comorbidities of HF are:1
anemia
sleep disturbance and sleep-disordered breathing
depression
cachexia
gout
angina
prostatic obstruction
hypertension
diabetes mellitus
coronary artery disease-AMI
hyperlipidemia
1. National Clinical Guideline Centre. (2010) Chronic heart failure: the management of chronic heart failure in adults in primary and secondary care. London: National Clinical Guideline Centre.

3. Methods I
Type of study: Systematic Review
Pubmed and Cochrane Library, were searched for original studies on patients with HF and comorbidities
Inclusion Criteria
Date of publication (last 5 years)
Language (Greek - English)
Age of population (adults 18 years and older)
Evidence based Guidelines
Meta-analysis
RCTs
Systematic Reviews
Studies related with our clinical question
Studies related with Primary Health Care

4. Results I
Figure 1. Flow chart of systematic review of the literature about HF and comorbidities

5. Results II
Figure 2. Management of HF and Comorbidities in PHC in Greece

6. Results III
So, PHC professionals must be trained in order to improve prescribing practices and non-pharmacological therapeutic options with a focus on patients centered care and always in collaboration with cardiologist/hospitals and community programs. 2,3
2. National Heart Foundation of Australia. A systematic approach to chronic heart failure care: a consensus statement. Melbourne: National Heart Foundation of Australia, 2013.
3. Ekman I, Wolf A, Olsson L-E, et al. Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. Eur Heart J 2012;33:1112

7. Implication/Impact of the study
The implementation of Greek Guidelines about HF in PHC with a combination of the results of this study should :
Improve the diagnosis, treatment and follow-up of patients
Reduce hospitalization
Improve the personalized medicine in primary care
Improve the quality of care
Reduce the healthcare expenses
Increase the patience adherence
Improve the referral policy
Also the main findings of this study may also have application to other national health care systems in countries with similar contex and infrastructure.

8. Conclusion
This study is anticipated to be a supportive tool which summarizes and evaluates all available scientific data about heart failure and comorbidities in order to provide guidance for PHC professionals into clinical practice and to improve the quality of health care services.

9. Thank you for your attention
Contact Information
Chrysanthi Tatsi:
Theodore Vasilopoulos:
Christos Lionis: