Chronic heart failure (HF) is 1 of the most common
reasons for hospitalization in patients aged
65 years and older.1 However, many hospitalizations
for HF are potentially preventable2 if the warning
signs of decompensation are recognized and treated
before the situation becomes emergent.3 Heart failure
is a prevalent and costly disease with significant
effects on quality of life. Successful management of
HF is complex and requires ongoing monitoring on
the part of clinicians, as well as education of patient
and family regarding appropriate medication use,
adherence to dietary and physical activity guidelines,
self-monitoring, and symptom management.4 Effective
outpatient HF programs may improve clinical
outcomes and reduce hospital readmissions by making
better use of outpatient resources.
Multicomponent outpatient HF management programs
have been the focus of numerous studies. More
recently, these types of interventions have been referred
to as ‘‘bundled’’ interventions. Bundled interventions
combine several individual interventions that are implemented
simultaneously. Probably the most widely
recognized types of bundled interventions are sepsis
bundles intended to prevent hospital-acquired infections.
5 Bundled interventions, such as multicomponent