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Current treatment of chronic heart failure in primary care; still room for improvement.

Abstract：

UNLABELLED:RATIONAL AND AIMS: In recent years, guidelines for treatment of patients with chronic heart failure (CHF) have been updated. Insight in current pharmacological and non-pharmacological treatment of CHF in primary care, which was non-optimal in earlier studies, is limited. We aim to describe current pharmacological and non-pharmacological treatment of CHF in primary care. METHODS:In this cross-sectional observational study, we included a representative sample of 357 patients diagnosed with CHF from 42 primary care practices in the Netherlands. We combined medical record data with data from patient and doctor questionnaires. RESULTS:Mean age of patients was 75.7 years (SD 10.2), 53% were male, and 73% of patients had mild heart failure (New York Heart Association class I or II). 76.5% of patients received diuretics. Angiotensin-converting enzyme inhibitors were prescribed in 40.6% and angiotensin-II receptor blockers in 20.7%; beta-blockers were prescribed to 54.6%, while 24.9% received spironolactone. Patients with more severe heart failure had a lower probability of being treated according to guideline recommendations. Relevant lifestyle advice was given to 40-60% of the patients, depending on the specific lifestyle advice. CONCLUSIONS:Implementation of evidence-based pharmacotherapy for heart failure in primary care has improved since clinical guidelines have been updated; especially with respect to prescription of beta-blockers. However, there still seems ample room for improvement, as in the case for providing lifestyle advice.

journal_name

J Eval Clin Pract

journal_title

Journal of evaluation in clinical practice

authors

Bosch M,Wensing M,Bakx JC,van der Weijden T,Hoes AW,Grol RP

doi

10.1111/j.1365-2753.2010.01455.x

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

644-50

issue

3

eissn

1356-1294

issn

1365-2753

pii

JEP1455

journal_volume

16

pub_type

杂志文章

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