Northern Territory perspectives on heart failure with comorbidities – understanding trial validity and exploring collaborative opportunities to broaden the evidence base

Heart Lung Circ. 2015 Jun;24(6):536-43. doi: 10.1016/j.hlc.2014.12.007. Epub 2014 Dec 24.

Abstract

Congestive Heart Failure (CHF) is an ambulatory care sensitive condition, associated with significant morbidity and mortality, rarely with cure. Outpatient based pharmacological management represents the main and most important aspect of care, and is usually lifelong. This narrative styled opinion review looks at the pharmacological agents recommended in the guidelines in context of the Northern Territory (NT) of Australia. We explore the concept of validity, a term used to describe the basis of standardising a particular trial or study and the population to which it is applicable. We aim to highlight the problems of the current guidelines based approach. We also present alternatives that could utilise the core principles from major trials, while incorporating regional considerations, which could benefit clients living in the NT and remote Australia.

Keywords: Guidelines; Heart Failure; Indigenous Australians; Remote; Rural; Therapeutics.

Publication types

  • Review

MeSH terms

  • Australia
  • Cardiovascular Agents / administration & dosage*
  • Clinical Trials as Topic
  • Comorbidity
  • Evidence-Based Medicine
  • Female
  • Health Services, Indigenous / organization & administration*
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Humans
  • Male
  • Northern Territory
  • Outcome Assessment, Health Care*
  • Practice Guidelines as Topic
  • Remote Consultation / methods*
  • Reproducibility of Results

Substances

  • Cardiovascular Agents