Awareness and perception of heart failure among European cardiologists, internists, geriatricians, and primary care physicians

Remme, Willem J.; McMurray, John J.V.; Hobbs, FD Richard; Cohen‐Solal, Alain; López‐Sendón, José; Boccanelli, Alessandro; Zannad, Faı̈ez; Rauch, Bernhard; Keukelaar, Karen; Macarie, Cezar; Rużyłło, Witold; Cline, Charles

doi:10.1093/eurheartj/ehn196

Cited by 91 publications

(80 citation statements)

References 26 publications

(17 reference statements)

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“…In the Study on Heart failure Awareness and Perception Europe and EuroHeart Failure studies, effective first‐line medications were underutilized and/or prescribed at subtherapeutic doses in many patients with HF 5, 6. The CORE survey provides a current snapshot of prescribing practices on a global level and suggests that cardiologists and PCPs appeared to prescribe diuretics, MRAs, and other common HF medications at rates and/or doses that are inconsistent with guideline recommendations.…”

Section: Discussionmentioning

confidence: 99%

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Clinical practices and attitudes regarding the diagnosis and management of heart failure: findings from the CORE Needs Assessment Survey

et al. 2017

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AimsCORE is a continuing medical education initiative designed to support the evidence‐based management of heart failure (HF) in the primary and secondary care settings. The goal of the CORE Needs Assessment Survey is to describe current clinical practice patterns and attitudes among global stakeholders in HF care.Methods and resultsThe CORE Steering Committee guided the development of survey questions to assess clinical practice, confidence, and attitudes/perceptions among cardiologists, primary care physicians, and nurses involved in HF management. In total, 346 healthcare professionals from Australia (n = 59), Austria (n = 59), Canada (n = 60), Spain (n = 58), Sweden (n = 52), and the UK (n = 58) contributed survey data. Results revealed multiple gaps over the spectrum of HF care, including diagnosis (low recognition of the signs and symptoms of HF and limited use of diagnostic tests), treatment planning (underuse of recommended agents and subtherapeutic dosing), treatment monitoring and adjustment (lack of adherence to recommendations), and long‐term management (low confidence in providing patient education). Although primary care and specialist physicians and nurses shared common unmet needs, healthcare professional‐specific clinical gaps were also identified.ConclusionsThe CORE Needs Assessment Survey provides timely data describing current clinical practices and attitudes among physicians and nurses regarding key aspects of HF care. These findings will be useful for guiding the development of interventions tailored to the specific educational needs of different provider types and designed to support the evidence‐based care of patients with HF.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, the effective diagnosis and treatment of patients with HF are essential 3, 4. However, many patients with HF are not receiving treatments and/or appropriate doses that demonstrate benefit in clinical trials and are not receiving care within a multidisciplinary framework that emphasizes effective long‐term management 5, 6, 7…”

Section: Introductionmentioning

confidence: 99%

Clinical practices and attitudes regarding the diagnosis and management of heart failure: findings from the CORE Needs Assessment Survey

et al. 2017

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“…[15][16][17] The specialised subject of our questionnaire could have contributed to the low response, but it is also likely that our study overestimates the average level of knowledge of cardiologists. Doctors are more likely to fill out a questionnaire on a subject that they are knowledgeable about.…”

Section: Discussionmentioning

confidence: 94%

Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: Dutch cardiologists and the care of mutation carriers

Vehmeijer¹,

Christiaans²,

Langen³

et al. 2010

NETH. HEART JOURN.

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Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: Dutch cardiologists and the care of mutation carriers Background. Patients with hypertrophic cardiomyopathy (HCM) and HCM mutation carriers are at risk of sudden cardiac death (SCD). Both groups should therefore be subject to regular cardiological testing -including risk stratification for SCD -according to international guidelines. We evaluated Dutch cardiologists' knowledge of and adherence to international guidelines on risk stratification and prevention of SCD in mutation carriers with and without manifest HCM. Methods. A questionnaire was sent to 1109 Dutch cardiologists (in training) containing case-based questions. Results. The response rate was 21%. Own general knowledge on HCM care was rated as insufficient by 63% of cardiologists. The percentage of correct answers (i.e. in agreement with international guidelines), on the case-based questions ranged from 37 to 96%, being lowest in cases with an unknown number of risk factors for SCD. A substantial portion of correct answers was based on the correct answer 'ask an expert opinion'. Significantly more correct answers were provided in cases with manifest HCM. There was little difference between the answers of cardiologists with different self-reported levels of knowledge, with different numbers of HCM patients in their practice or with different numbers of carriers without manifest HCM. Conclusion. Knowledge on risk stratification and preventive therapy was mediocre, and knowledge gaps exist, especially on HCM mutation carriers without manifest disease. Fortunately, experts are frequently asked for their opinion which might bring patient care to an adequate level. Hopefully, our results will stimulate cardiologists to follow developments in this field, thereby increasing quality of care for HCM patients and mutation carriers. (Neth Heart J 2009:17:464-9.).Keywords: Hypertrophic cardiomyopathy, risk stratification, sudden cardiac death, questionnaire With a prevalence of about one in 500, hypertrophic cardiomyopathy (HCM) is one of the most common genetic diseases.1 HCM is inherited as an autosomal dominant trait caused by a large variety of mutationsaround 450 different mutations in more than 11 genes have been reported.2 HCM is clinically classified as a (usually asymmetric) thickening of the myocardial wall of the left ventricle, often involving the interventricular septum, which cannot be accounted for by other clinical diseases. 3,4 Most patients experience few if any symptoms. If present, symptoms are diverse. Common symptoms are chest pain during exertion and dyspnoea. 5The most feared complication of HCM is sudden cardiac death (SCD) with an annual incidence of 1% in unselected HCM patients. 6 Although SCD in HCM predominantly occurs in young asymptomatic adults According to a consensus document from the American College of Cardiology (ACC) and the European Society of Cardiology (ESC), HCM patients (with manifest disease) and mutation carriers (with or without manifest disea...

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“…60 • Assess number of heart failure health care provider services as patients may be receiving mixed or confusing advice. 61 Issue 4: Be aware of laboratory and clinical parameters that may be helpful in determining hypervolemia, renal dysfunction that aggravates hypervolemia, 8 or other medical conditions associated with decreased cardiac output and neuroendocrine activation leading to hypervolemia. 1,28,62,63 • Assess creatinine clearance (estimated glomerular filtration rate).…”

Section: Issuementioning

confidence: 99%

Fluid Management Strategies in Heart Failure

Albert

2012

Critical Care Nurse

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In patients with chronic heart failure, fluid retention (or hypervolemia) is often the stimulus for acute decompensated heart failure that requires hospitalization. The pathophysiology of fluid retention is complex and involves both hemodynamic and clinical congestion. Signs and symptoms of both hemodynamic and clinical congestion should be assessed serially during hospitalization. Core heart failure drug and cardiac device therapies should be provided, and ultrafiltration may be warranted. Critical care, intermediate care, and telemetry nurses have roles in both assessment and management of patients hospitalized with acute decompensated heart failure and fluid retention. Nurse administrators and managers have heightened their attention to fluid retention because the Medicare performance measure known as the risk-standardized 30-day all-cause readmission rate after heart failure hospitalization can be attenuated by fluid management strategies initiated by nurses during a patient’s hospitalization.

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Awareness and perception of heart failure among European cardiologists, internists, geriatricians, and primary care physicians

Abstract: Although each physician group lacks complete adherence to guideline-recommended management strategies, these are used significantly less well by I, G, and PCPs, indicating the need for education of these essential healthcare providers.

Cited by 91 publications

References 26 publications

Clinical practices and attitudes regarding the diagnosis and management of heart failure: findings from the CORE Needs Assessment Survey

Clinical practices and attitudes regarding the diagnosis and management of heart failure: findings from the CORE Needs Assessment Survey

Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: Dutch cardiologists and the care of mutation carriers

Fluid Management Strategies in Heart Failure

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