Evaluation of a primary care based (family physicians) HF management strategy in patients with heart failure in the community

Cluster randomized clinical trial (family physician is cluster) evaluating a primary care based heart failure management strategy

Inclusion Criteria:

1. Men and women, age more or equal to 65 years AND

2. Diagnosis of HF confirmed with the following criteria:

   1. Previous hospital admission for HF OR
   2. Definite HF confirmed with the Boston HF criteria OR
   3. Possible HF confirmed with the Boston HF criteria AND evidence of left ventricular systolic dysfunction (left ventricular ejection function <40%) on echocardiography, radionuclide angiography, or left ventricular angiogram documented in the patient's family physicians clinic chart.

Exclusion Criteria:

1. Patients with terminal illness (e.g. cancer) with a life expectancy of less than one year.
2. Patients in a long-term-care facility with nursing care.
3. Patients awaiting cardiac surgery for correctable causes of HF (e.g., severe valvular disease or extensive ischemia) during the study period.
4. Patients expected to be away from the country during the intervention period for a duration of >3 months.
5. Patients unable or refusing to sign consent.
6. Patients currently followed in the Hamilton Health Sciences HF clinic. These patients are excluded as they are currently enrolled in a HF disease management strategy.
7. Patients currently enrolled in another clinical trial.