Abstract
Background/Aims: Despite strong evidence for the treatment of CHF from large clinical trials, systematic review and meta-analysis, many patients are not treated according to guidelines. In addition only 8–11% of CHF patients receive specialist CHF management. The purpose of this study was to review the management of CHF outside of specialist programs.
Methods: A prospective clinical audit design was utilised.
Results: Between 1st August and 1st October, a total of 3698 inpatients were screened leading to the review of 81 eligible patients. The mean age of this group was 81.2 (±9.4) years; 48.1% were male; most patients were in New York Heart Association Class II (23.5%) or III (37.0%); mean number of co-morbidities was 8 (±3); mean number of routine medicines was 9 (±3); median length of stay per admission was 9 days (range 2–65). 53.1% had a previous echocardiogram.
On discharge 59.2% were prescribed angiotensin converting enzyme inhibitors (ACE-I) and 43.1% prescribed beta-blockers. During hospitalisation 8.6% were started on an ACE-I and 4.9% on a beta-blocker. There was evidence of under treatment and lack of uptitration both for ACE-I (18.5% and 7.4%) and beta-blockers (29.3% and 17.3%). 24.5% were receiving “gold standard practice” (combination of echocardiogram, ACE-I and beta-blocker). Education regarding non-pharmacological advice was poorly documented. The results from this study compared with international reports regarding the under treatment of CHF.
Conclusion: Management of this complex group of patients both within the community and hospital still needs improvement to meet the recommended practice presented in guidelines for CHF.
Methods: A prospective clinical audit design was utilised.
Results: Between 1st August and 1st October, a total of 3698 inpatients were screened leading to the review of 81 eligible patients. The mean age of this group was 81.2 (±9.4) years; 48.1% were male; most patients were in New York Heart Association Class II (23.5%) or III (37.0%); mean number of co-morbidities was 8 (±3); mean number of routine medicines was 9 (±3); median length of stay per admission was 9 days (range 2–65). 53.1% had a previous echocardiogram.
On discharge 59.2% were prescribed angiotensin converting enzyme inhibitors (ACE-I) and 43.1% prescribed beta-blockers. During hospitalisation 8.6% were started on an ACE-I and 4.9% on a beta-blocker. There was evidence of under treatment and lack of uptitration both for ACE-I (18.5% and 7.4%) and beta-blockers (29.3% and 17.3%). 24.5% were receiving “gold standard practice” (combination of echocardiogram, ACE-I and beta-blocker). Education regarding non-pharmacological advice was poorly documented. The results from this study compared with international reports regarding the under treatment of CHF.
Conclusion: Management of this complex group of patients both within the community and hospital still needs improvement to meet the recommended practice presented in guidelines for CHF.
| Original language | English |
|---|---|
| Pages (from-to) | S145-S145 |
| Number of pages | 1 |
| Journal | Heart, Lung and Circulation |
| Volume | 17 |
| Issue number | Suppl_3 |
| DOIs | |
| Publication status | Published - Aug 2008 |
| Event | Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research, Australasian Section, Annual Scientific Meeting 2008 - Adelaide, Australia Duration: 7 Aug 2008 → 10 Aug 2008 |
Keywords
- guidelines
- CHF management