Multiprofessional Interventions for Frailty in Patients with Heart Failure: A Comprehensive Review.

PURPOSE OF REVIEW: Frailty is a prevalent and clinically significant condition affecting up to 45% of adults with heart failure (HF). Frailty reflects a state of reduced physiologic reserve and vulnerability to stressors, which profoundly influences health outcomes including health care utilization and survival. Frailty and HF interact through multiple overlapping pathophysiologic mechanisms, including chronic inflammation, neurohormonal abnormalities, and multiorgan dysfunction. This synergy, for the patient leads to poor physical performance, reduced independence, and a greater susceptibility to complications. RECENT FINDINGS: Evidence from recent clinical trials focused on frailty in HF underscores the potential benefits of multicomponent interventions combined with medication optimisation target physical dysfunction, poor nutrition, psychological disorders, and social isolation. Multidisciplinary care teams - including cardiologists, nurses, physical therapists, dieticians, occupational therapists, and social workers - can implement tailored strategies to reverse or slow the progression of frailty to improve health outcomes of patients with HF. Interventions such as resistance and balance training, individualised nutritional supplementation, medication review, cognitive and psychological support, and caregiver education have demonstrated a range of benefits in HF, from enhanced physical capacity and reduced hospital readmissions to improved health-related quality of life. Managing frailty in patients with HF requires a personalised, holistic and multicomponent approach. Successful intervention involves addressing not only physical dysfunction but also psychological, nutritional, and social factors that collectively undermine health and independence. Integrating multicomponent care into routine practice has the potential to improve clinical outcomes, reduce health care utilisation, and enhance the overall well-being of patients. Future research should aim to identify the most effective combinations of interventions, clarify mechanisms of action, and determine cost-efficiency in health care delivery.