PRIMARY CARE PROBLEMS IN PATIENTS WITH CHRONIC HEART FAILURE
https://doi.org/10.20996/1819-6446-2013-9-5-500-504
Abstract
Aim. To evaluate primary care efficacy in patients with chronic heart failure (CHF).
Material and methods. Outpatients (n=139) with CHF and 35 primary care physicians were included into the study. The evaluation of drug therapy and patient awareness of the principles of non-drug CHF treatment were performed. An anonymous survey among doctors in terms of current CHF guidelines knowledge, patient information provided by physicians, and doctors’ burnout status was also carried out.
Results. Only 39% and 10% of CHF outpatients received target doses of ACE inhibitors/sartans and beta-blockers, respectively. Majority of CHF outpatients and their doctors need in additional education/training. 56% of primary care physicians demonstrated an emotional burnout.
Conclusion. Author considers it essential to distribute short pocket-guidelines on CHF management among primary care physicians, and to reduce the load on primary care physicians with simultaneous strengthening of their performance control.
About the Author
O. A. Shtegman
Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky, Krasnoyarsk
Russian Federation
Russian Federation
References
1. Swedberg K. What should we do about heart failure: challenges for 2009. Eur J Heart Fail 2009; 11(1): 1-2.
2. Maggioni AP, DahlstrЪm U, Filippatos G, et al. EURObservational Research Programme: The Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail 2010; 12 (10):1076-84
3. Dahlstrom U, Hakansson J, Swedberg K, Waldenstrom A. Adequacy of diagnosis and treatment of chronic heart failure in primary health care in Sweden. Eur J Heart Fail 2009; 11:92-8.
4. National guidelines for the diagnosis and treatment of chronic heart failure (third revision). Heart failure 2010, 11 (1): 69-160. Russian (Национальные рекомендации по диагностике и лечению хронической сердечной недостаточности (третий пересмотр). Сердечная Недостаточность 2010; 11 (1): 69-160).
5. Boyko V. Diagnosis of burnout personality. In: Fetiskin NP, VV Kozlov, Manuilov GM. Socio-psychological diagnosis of personality development and small groups. Moscow: Publishing House of the Institute of Psychotherapy; 2002: 394-399. Russian (Бойко В.В. Диагностика эмоционального выгорания личности. В: Фетискин Н.П., Козлов В.В., Мануйлов Г.М. Социально-психологическая диагностика развития личности и малых групп. М.: Издательство Института Психотерапии; 2002: 394-9).
6. Kesselheim AS, Misono AS, Shrank WH, et al. Variations in pill appearance of antiepileptic drugs and the risk of nonadherence. JAMA Intern Med 2013; 173(3):202-8.
7. Yu LX, Geba GP. Generic pills from the patient perspective: Dressed for success? JAMA Intern Med 2013; 173(3):208-9.
8. Ageeyev FT, Fofanova TV, Drobizhev MB et al. Free or fixed combination of enalapril and hydrochlorothiazide in real ambulatory practice: what is best for the patient of hypertension? Comparison of the effectiveness and adherence to treatment. Kardiologiia 2008; 48 (5) :10-5. Russian (Агеев Ф.Т., Фофанова Т.В., Дробижев М.Б. и др. Свободная или фиксированная комбинация эналаприла и гидрохлортиазида в реальной амбулаторной практике: что лучше для больного АГ? Сравнение эффективности и приверженности к лечению. Кардиология 2008; 48 (5):10-5).
9. Benson J, Britten N. Patients’ views about taking antihypertensive drugs: questionnaire study. BMJ 2003; 326 (7402):1314 15
10. Erhardt L, Komajda M, Hobbs FD, Soler-Soler J. Cardiologists' awareness and perceptions of guidelines for chronic heart failure. The ADDress your Heart survey. Eur J Heart Fail 2008; 10:1020-5.
11. Maggioni AP, Sinagra G, Opasich C, et al. Treatment of chronic heart failure with beta adrenergic blockade beyond controlled clinical trials: the BRING-UP experience. Heart 2003; 89:299-305.
12. Minakov EV, R. Khokhlov, Furmenko GI, Ahmedjanov NM. Clinical inertia as a factor preventing effective treatment of cardiovascular diseases. Rational Pharmacother Card 2009; (2):39-48. Russian (Минаков Э.В., Хохлов Р.А., Фурменко Г.И., Ахмеджанов Н.М. Клиническая инертность как фактор, препятствующий эффективному лечению сердечно-сосудистых заболеваний. Рациональная Фармакотерапия в Кардиологии 2009; (2):39-48).
Review
For citations:
Shtegman O.A. PRIMARY CARE PROBLEMS IN PATIENTS WITH CHRONIC HEART FAILURE. Rational Pharmacotherapy in Cardiology. 2013;9(5):500-504. (In Russ.) https://doi.org/10.20996/1819-6446-2013-9-5-500-504
Views:
805
Email this article 