NATIONAL SERVICE FRAMEWORK'S CALL FOR SPECIALIST CLINICS: SUCCESS OF A NURSE LED HEART FAILURE CLINIC FOR SAFE INITIATION AND UP TITRATION OF KEY THERAPEUTIC AGENTS.

This article focuses on a National Service Framework's call for specialist clinics in Great Britain. Heart failure has a poor prognosis, yet drugs known to improve outcomes are not prescribed, or prescribed at sub-therapeutic doses. The National Service Framework for Coronary Heart Disease recommended specialist heart failure clinics to address this problem, but their efficacy for safely improving prescription rates has not been evaluated. With regular follow up and careful auditing in a nurse led multidisciplinary heart failure clinic it is possible to achieve target doses of medication and improve symptoms without adverse effects on electrolytes or renal function.