I-HEART: Implementation of HEArt failure guidelines for patients with acute heart failure in Regional AusTralia

INTERVENTION: The intervention will be delivered by telehealth between specialists in a metropolitan health service and health professionals in a regional health service 1) One appointment of one hour telehealth review by a heart failure (HF) Cardiologist (from a metropolitan hospital) with the patient and their regional site Dr/GP by day 10 post‐discharge, and 2) five appointments each of one hour telehealth reviews by a HF nurse practitioner from a metropolitan hospital, in conjunction with the regional site community outreach nurse and patient by day five and then weekly for 28 days post‐discharge The purpose of the review by the HF Cardiologist is to review the HF patients post‐discharge and to develop a management plan with the patient and their local Dr/GP. The purpose of the review by the HF nurse practitioner is to prescribe and titrate medications and provide education about HF based on the Heart Foundation HF patient resource. The telehealth review protocol is designed specifically for this study No training is required by the cardiologist and nurse practitioner as both are qualified and experts in the field. Each telehealth consultation will collect data about the treatment and management plans implemented during the consultations. These consultations will not be recorded. CONDITION: Cardiovascular ‐ Coronary heart disease Heart failure; ; Heart failure Public Health ‐ Health service research PRIMARY OUTCOME: Composite outcome of all‐cause rehospitalisations and all‐cause mortality at 12 months from the time of discharge. This will be collected by data linkage with hospital medical records[12 months post‐discharge] SECONDARY OUTCOME: Composite outcome if the patient was prescribed, when medically indicated, beta‐blockers, angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), or angiotensin receptor neprilysin inhibitors (ARNIs); and mineralocorticoid receptor antagonists (MRAs). This will be collected from medical records and telehealth clinic notes.[30 days post‐discharge] The patient received a telehealth visit from a Cardiologist within 10 days of discharge. This will be collected during the telehealth visit[10 days post‐discharge] The patient received a telehealth visit from a HF nurse practitioner with the local community outreach service within five days of discharge. This will be collected during the telehealth visit[5 days post‐discharge] INCLUSION CRITERIA: All patients admitted to the regional health service with acute heart failure, aged over 17 years, who are discharged alive and not transferred to palliative care or another hospital.