Evidence-based management of chronic heart failure (CHF): A comparison of the pre-admission and post-hospital treatment features of patients not enrolled in specialist management programs

Johanna Borgstedt, Robyn Clark, Desmond Colley, Gunner Tobin, Sepehr Shakib

    Research output: Contribution to journalMeeting Abstract

    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.
    Original languageEnglish
    Pages (from-to)S145-S145
    Number of pages1
    JournalHeart, Lung and Circulation
    Volume17
    Issue numberSuppl_3
    DOIs
    Publication statusPublished - Aug 2008
    EventCardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research, Australasian Section, Annual Scientific Meeting 2008 -
    Duration: 7 Aug 2008 → …

    Keywords

    • guidelines
    • CHF management

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