Practical management of heart failure in hospital at home: recommendations from the Spanish Society of Internal Medicine and the Spanish Society of Hospital at Home

Abstract

Heart failure (HF) is a major cause of morbidity, mortality, and hospital admissions worldwide. Home hospitalization (HaH) has emerged as an effective alternative, enhancing patient care and optimizing healthcare resources. This expert consensus document, endorsed by the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Home Hospitalization (SEHAD), provides practical recommendations for the management of HF in HaH settings. It outlines patient selection criteria, parameters for assessing congestion, and treatment protocols. The document emphasizes the use of telemonitoring and point-of-care ultrasound (POCUS). Therapeutic optimization, clinical follow-up, and patient education are fundamental. It also addresses comorbidity management and the integration of palliative care. Certification of HF care units and the strengthening of interdisciplinary collaboration are key to improving healthcare quality. HaH presents itself as an effective strategy for the comprehensive management of HF, reducing hospital-related complications and promoting patient-centered care.

Keywords: Congestion; Congestión; Cuidados paliativos; Diuretics; Diuréticos; Ecografía; Heart failure; Home hospitalization; Hospitalización a domicilio; Insuficiencia cardíaca; Palliative care; Telemonitoring; Telemonitorización; Ultrasound.