What is the most cost effective and clinically beneficial route of administration of diuretics for people with advanced heart failure living in the community?
The most cost effective and clinically beneficial route of administration of diuretics for people with advanced heart failure living in the community is subcutaneous diuretics (furosemide or torsemide) +/- oral metolazone/thiazides. This is according to the National Institute for Health and Care Excellence (NICE) 2018 guidelines, which suggest that subcutaneous diuretics are the most effective route for the management of fluid overload in this population. In addition, this route has been shown to reduce unplanned hospitalizations and improve quality of life compared to oral diuretics, IV diuretics, and IV diuretics with oral metolazone/thiazides.