Adherence to the ESC Heart Failure Treatment Guidelines in Spain: ESC Heart Failure Long-term Registry

Crespo‐Leiro, María G.; Segovia‐Cubero, Javier; González-Costello, José; Bayés‐Genís, Antoni; López-Fernández, Silvia; Roig, Eulàlia; Sanz-Julve, Marisa; Fernández-Vivancos, Carla; Mora-Martín, Manuel de; García‐Pinilla, José Manuel; Román, Alfonso Varela; Almenar‐Bonet, Luis; Lara-Padrón, Antonio; Fuente-Galán, Luis de la; Delgado-Jiménez, Juan

doi:10.1016/j.rec.2015.03.008

Cited by 32 publications

(32 citation statements)

References 16 publications

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“…More recently, similar results have been obtained in Spain,5 with 30.3, 30, 34.6, and 26.7% patients found to be in the process of titration of ACEIs, ARBs, BBs, and MRAs, respectively, the target dose of these drugs being reached in just 16.2, 23.3, 13.2, and 23.5% of patients. Further, the reason why the target dose was not reached was unknown in 27.8, 25.7, 28.5, and 50.1% of patients on ACEIs, ARBs, BBs, and MRAs, respectively.…”

Section: Introductionsupporting

confidence: 79%

Design of a multicentre randomized controlled trial to assess the safety and efficacy of dose titration by specialized nurses in patients with heart failure. ETIFIC study protocol

et al. 2017

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AimsHeart failure (HF) is associated with many hospital admissions and relatively high mortality, rates decreasing with administration of beta‐blockers (BBs), angiotensin‐converting‐enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists. The effect is dose dependent, suboptimal doses being common in clinical practice. The 2012 European guidelines recommend close monitoring and dose titration by HF nurses. Our main aim is to compare BB doses achieved by patients after 4 months in intervention (HF nurse‐managed) and control (cardiologist‐managed) groups. Secondary aims include comparing doses of the other aforementioned drugs achieved after 4 months, adverse events, and outcomes at 6 months in the two groups.MethodsWe have designed a multicentre (20 hospitals) non‐inferiority randomized controlled trial, including patients with new‐onset HF, left ventricular ejection fraction ≤40%, and New York Heart Association class II–III, with no contraindications to BBs. We will also conduct qualitative analysis to explore potential barriers to and facilitators of dose titration by HF nurses. In the intervention group, HF nurses will implement titration as prescribed by cardiologists, following a protocol. In controls, cardiologists will both prescribe and titrate doses. The study variables are doses of each of the drugs after 4 months relative to the target dose (%), New York Heart Association class, left ventricular ejection fraction, N‐terminal pro B‐type natriuretic peptide levels, 6 min walk distance, comorbidities, renal function, readmissions, mortality, quality of life, and psychosocial characteristics.ConclusionsThe trial seeks to assess whether titration by HF nurses of drugs recommended in practice guidelines is safe and not inferior to direct management by cardiologists. The results could have an impact on clinical practice.

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Section: Introductionsupporting

confidence: 79%

Design of a multicentre randomized controlled trial to assess the safety and efficacy of dose titration by specialized nurses in patients with heart failure. ETIFIC study protocol

et al. 2017

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“…En el mismo sentido se orientan los estudios sobre la demora entre descubrimiento y aplicación 11 . En cardiología existen abundantes estudios sobre el cumplimiento de las recomendaciones derivadas de la investigación tanto sobre prevención 12 como sobre tratamiento 13 , y asimismo se ha investigado la asociación de dicho cumplimiento con la mejor calidad asistencial y mejores resultados en salud (como en el caso de las guías sobre síndrome coronario agudo). La profundización en el conocimiento de los mecanismos por los que esos hallazgos se producen o se dificultan y su relación con proyectos específicos entra de lleno en el campo de la RIA.…”

Section: Principales Contribuciones De La Ria En Cardiología Hasta Launclassified

The Social Impact of Cardiology Research: Beyond Management

Permanyer-Miralda

Hinrichs

Adam

2016

Revista Española de Cardiología (English Edition)

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“…Target doses were more easily achieved in patients with elevated natriuretic peptide levels and hypertensive patients. In another trial conducted in Spain, target doses were achieved with ACEI, ARB, BB and MRA therapies in 16.2%, 23.3%, 13.2% and 23.5% of the HF patients, respectively (28). Even though target doses were not achieved after CRT, use of higher doses of neurohumoral blockers had favorable effects on survival (29).…”

Section: 8mentioning

confidence: 99%

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

Çavuşoğlu

Altay²,

Ekmekçi³

et al. 2015

Anatol J Cardiol

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Practical approaches for the treatment of chronic heart failure:Frequently asked questions, overlooked points and controversial issues in current clinical practiceHeart failure (HF) is a progressive disorder associated with impaired quality of life, high morbidity, mortality and frequent hospitalization and affects millions of people from all around the world. Despite further improvements in HF therapy, mortality and morbidity remains to be very high. The life-long treatment, frequent hospitalization, and sophisticated and very expensive device therapies for HF also leads a substantial economic burden on the health care system. Therefore, implementation of evidence-based guideline-recommended therapy is very important to overcome its worse clinical outcomes. However, HF therapy is a long process that has many drawbacks and sometimes HF guidelines cannot answers to every question which rises in everyday clinical practice. In this paper, commonly encountered questions, overlooked points, controversial issues, management strategies in grey zone and problems arising during follow up of a HF patient in real life clinical practice have been addressed in the form of expert opinions based on the available data in the literature. (Anatol J Cardiol 2015: 15 Suppl 2; 1-60)

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Adherence to the ESC Heart Failure Treatment Guidelines in Spain: ESC Heart Failure Long-term Registry

Cited by 32 publications

References 16 publications

Design of a multicentre randomized controlled trial to assess the safety and efficacy of dose titration by specialized nurses in patients with heart failure. ETIFIC study protocol

Design of a multicentre randomized controlled trial to assess the safety and efficacy of dose titration by specialized nurses in patients with heart failure. ETIFIC study protocol

The Social Impact of Cardiology Research: Beyond Management

Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice

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