Team Medicine for CHF Treatment.

The mortality associated with end stage heart failure (HF) is high, despite the development of new and increasingly effective drugs and non-pharmacological therapies. Repetitive hospitalizations predict fatal outcomes, and each hospitalization should prompt individual conversations with the patient, the family and the caregivers. A multidisciplinary disease management program promotes the education of patients and their families, and modifies their behaviour, with a view to ultimately improving the prognosis and quality of life. Beginning with the earliest stages of HF, on through the late stages, a multidisciplinary disease management program should be implemented.