Updated Wednesday,20December2023 - 17:08

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Although it is the patients themselves who are the first to experience a significant negative impact on their lives,3 this pathology is underdiagnosed because the symptoms are confused with those of other pathologies and are attributed to the deterioration of the person's own aging. Despite this, it is estimated that 1 in 5 people 4 will develop heart failure in their lifetime, and in Spain it already affects more than 700,000 people5. Heart failure, in general terms, presents a major challenge both globally (affecting more than 60 million people worldwide6) and in Spain, with more than 107,000 hospital admissions per year7 and a high mortality rate.

In this context, and anticipating the health challenges of the future, in 2021 the pharmaceutical company Boehringer Ingelheim promoted, with the help of a multidisciplinary committee of experts (doctors from different specialties, managers, nursing, patient associations, among other decisive actors), a paradigm shift in the models of care for patients with heart failure, to provide higher quality care to patients with this pathology and thus offer a better quality of care. Integrated care that improves health outcomes.

This effort was embodied in the MAIC (Models of Care for Patients with Heart Failure) program, which focuses on seven key areas to improve patient care: development of heart failure management models, rapid and accurate diagnosis, optimization of inpatient care, improvement of continuity of care, Planning and coordination of chronic follow-up of the pathology, development of the role of nursing and reinforcement of the training of professionals involved in the management of heart failure.

MAIC Conference, sharing experiences to improve the approach to heart failure

The MAIC Conference is a meeting forum for all professionals who have a relevant role in the approach to heart failure, whether they are managers or health professionals from different specialties (Cardiology, Internal Medicine, Family and Community Medicine, Epidemiology, Nursing, Management and Patient Associations).

In 2022, the I MAIC Conference served to explain the theoretical framework and roadmap of the program. A year later, at the II MAIC Conference, which brought together more than 18 health workers on 130 October, it was possible to analyse practical cases of implementation of MAIC, both at the regional level and for MAIC Continuum, the specific project for hospital discharge. Thus, it has been possible to know how the program is being developed in some of the 10 Autonomous Communities and in the almost 25 hospitals spread throughout the Spanish geography where it is already being carried out. At the meeting, it was clear that there is a great consensus that actions focused on improving the comprehensive care of these patients result in positive results.

Another of the most repeated conclusions of the Conference was the need to measure and collect data on the care activity around patients with heart failure. As Dr. Josep Comín, coordinator of the program and member of MAIC's committee of experts, points out, "the indicator panels are the key piece of transformation to observe, evaluate and correct the processes and should be used to take action on how to make the care of these patients more efficient and improve health outcomes". With the same approach, Dr. José Ramón González Juanatey, Head of the Cardiology Service and Cardiology Critical Care Unit of the University Clinical Hospital of Santiago de Compostela, wanted to convey in his speech the need for professionals in the sector to ask themselves about the organization of heart failure care processes in their respective health areas and to measure it with quality indicators. To this end, Dr. González Juanatey specifies four indicators that he considers fundamental: measuring the response time of an internist or cardiologist to a request for primary care, recording the percentage of readmissions and verifying whether there is a structured visit with a checklist of indicators after discharge and, finally, also measuring the proportion of patients with optimized medical treatment according to the recommendations of the guidelines. With all these indicators, Dr. González Juanatey assures that "it would be possible to know how efficient the process is in my area, what opportunities for improvement it would have and take action. In addition, comparing and learning across organizations allows us to continue improving."

Another of the experts participating in the MAIC Conference, Dr. Álvaro González Franco, Director of the Internal Medicine Clinical Management Unit of the Central University Hospital of Asturias, points out that MAIC provides "the ability to systematize and coordinate the levels of care to achieve improvements at key moments: in early diagnosis, in adequate management of the transition to discharge or in adequate follow-up of chronic patients. In those critical moments, that's where MAIC brings us that benefit."

As Marta Carrera, Director of Market Access and Healthcare Affairs at Boehringer Ingelheim Spain, points out, "MAIC represents a paradigm shift in the care of patients with heart failure and reinforces the need for coordination between the different levels of care" and has the endorsement of the main leading scientific societies in this field. such as the Spanish Society of Cardiology (SEC), the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC), the Spanish Society of Health Executives (SEDISA) and the Spanish Society of Hospital Pharmacy (SEFH).

Dr. Comín is convinced that forums such as the MAIC Conference, which enable a real exchange between experts and experiences of implementation at the regional and local levels and in the transition of care, really allow the program to be scaled up to other health settings to continue improving the care of patients with heart failure.


[1] Spanish Heart Foundation

[2] American Heart Association. What is Heart Failure? Accessed May 2023

[3] Comín-Colet J, Anguita M, Formiga F, Almenar L, Crespo-Leiro M, Manzano L et al. Health-related quality of life of patients with systolic heart failure in Spain: results of the VIDA-IC study. Rev Esp Cardiol. 2016;59:256-71.

[4] Ponikowski, P. et al. Heart failure: preventing disease and death worldwide. ESC Heart Failure 2014; 1: 4-25 Published online 29 August 2014 in Wiley Online Library ( DOI:10.1002/ehf2.12005. Accessed May 2023.

[5] Sicras-Mainar A, Sicras-Navarro A, Palacios B, Varela L, Delgado JF. "Epidemiology and treatment of heart failure in Spain: PATHWAYS-HF study". Rev Esp de Cardiol 2020.

[6] GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and causespecific mortality for 249 causes of death, 1980-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Accessed January 2023.

[7] Rodríguez-Artalejo F, Banegas-Banegas JR G-CP. Epidemiology of heart failure. Rev Esp Cardiol. 2004; 57:163-70

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