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J Cardiol. 2015 Sep;66(3):181-8. doi: 10.1016/j.jjcc.2015.01.007. Epub 2015 Feb 23.

Multidisciplinary management of heart failure just beginning in Japan.

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Department of Cardiology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan. Electronic address:


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 behavior, with a view to ultimately improve the prognosis and quality of life. From the early to the late stages of HF, a multidisciplinary disease management program should be implemented. In Western societies this multidisciplinary management has long been debated and endorsed, in contrast to Japan, where it has just begun. In 2012, the Japanese Nursing Association launched a certification in chronic HF nursing. A Japanese version of HF disease management should soon be developed in its own social environment.


Cardiac cachexia; Heart failure; Heart failure management; Palliative care

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