Abstract

European Journal of Heart Failure 10 (2008) 331 ­ 333 www.elsevier.com/locate/ejheart Tiny Jaarsma, Dirk J. van Veldhuisen Department of Cardiology University Medical Center Groningen, The Netherlands Received 18 February 2008; accepted 27 February 2008 1. Introduction Heart failure (HF) is a major medical and epidemiological problem, and over the last 20 years a large number of studies have examined the value and place of several forms of disease management programmes for patients with heart failure [1]. These programmes have varied significantly in terms of how early in the disease process HF patients would need counselling and coaching (when), which forms and "dose" of counselling would be required and necessary (how), and lastly, in which setting such interventions should take place, i.e. in hospital or possibly outside the hospital (where). Despite these differences, many of these studies reported positive effects and as a result, disease management programmes are recommended in international HF guidelines, both in Europe and in the United States [2,3]. However, many of the studies were relatively small, and it also is not unlikely, that studies that found beneficial effects may have published relatively more frequently, than those that did not find such favourable effects, i.e. a