Thomas, Merlin C

2015-06-01

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.

Royal Darwin Hospital, Flinders University, Darwin Private Hospital, Tiwi, NT 0811. Electronic address: balaniyngkaran@hotmail.com..

Royal Darwin Hospital, Department of Nephrology Division of Medicine. Electronic address: william.majoni@nt.gov.au..

Menzies School of Health Research, Casuarina NT 0811. Electronic address: alan.cass@menzies.edu.au..

Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia. Electronic address: prash.sanders@adelaide.edu.au..

Department of Nephrology Dialysis & Transplantation, International Renal Research Institute (IRRIV) San Bortolo Hospital, Vicenza, Italy. Electronic address: cronco@goldnet.it..

Alice Springs Hospital, Alice Springs NT 0871. Electronic address: stephen.brady@nt.gov.au..

Division of Medicine, Royal Darwin Hospital, Royal Darwin Hospital, Tiwi, NT 0810. Electronic address: kanganada@gmail.co..

Royal Darwin Hospital, Royal Darwin Hospital, Tiwi, NT 0810. Electronic address: marcus.ilton@gmail.com..

Coordinator, Cardiovascular Research, University of Melbourne; Director of Heart Failure Services, Austin Health, Vic 3084. Electronic address: davidlh@unimelb.edu.au..

Baker IDI Heart and Diabetes Institute, Central Melbourne Victoria 3004, Australia. Electronic address: merlin.thomas@bakeridi.edu.au..

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

https://pubmed.ncbi.nlm.nih.gov/25637942/?otool=iaurydwlib

https://hdl.handle.net/10137/5513

Guidelines

Heart Failure

Indigenous Australians

Remote

Rural

Therapeutics

Australia

Cardiovascular Agents

Clinical Trials as Topic

Comorbidity

Evidence-Based Medicine

Female

Health Services, Indigenous

Heart Failure

Humans

Male

Northern Territory

Practice Guidelines as Topic

Remote Consultation

Reproducibility of Results

Outcome Assessment (Health Care)

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

Journal Article

Publication