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Heart failure patient's journey: clinical practices and attitudes regarding the diagnosis and management of heart failure

Session Poster Session 4

Speaker Michael Boehm

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Multidisciplinary Interventions
  • Session type : Poster Session

Authors : M Boehm (Homburg, Saar,DE), I Kindermann (Homburg, Saar,DE)

Authors:
M Boehm1 , I Kindermann1 , 1Internal Medicine Clinic III, Saarland University Clinic, Saarland University - Homburg, Saar - Germany ,

Citation:

Background. Multiple studies have identified gaps and challenges in current heart failure (HF) care. A better understanding of the patient journey could be useful for tailoring educational interventions to address knowledge and practice gaps in the long-term management in HF. This survey assessed the attitudes and perceptions of the different health care professionals (HCPs) involved in HF patient management at different steps of the HF patient’s journey.

Method. A total of 25 intensive care unit (ICU) cardiologists, 34 non–ICU cardiologists, and 25 primary care physicians (PCPs) from France, Germany, Spain, the UK, and Russia were interviewed between March and April 2018.

Results: Cardiologists and primary care physicians reported that HF was diagnosed in 70% of patients in the hospital following an acute decompensation or an ischemic event and in 30% of patients in an outpatient setting. Up to 30% of patients diagnosed in the hospital seemed to be referred to the hospital by an office-based physician. A majority of HF patients get to the hospital in an ambulance or emergency truck.

PCPs are generally seen within 1 week after discharge / diagnosis. Cardiologists are generally seen within 1 month for severe patients or up to 3 months for most patients. Up to 10% of patients may not come back for follow-up consultations.

Physicians estimate that approximately 30% to 40% of patients diagnosed with HFREF decompensate and they are readmitted to the hospital within weeks or months after diagnosis. The main reasons for decompensation declared involved respiratory infections, difficulties to see and monitor patients as frequently as needed, difficulties to continue the titration process in an outpatient setting, difficulties to provide appropriate and comprehensive patient education, lack of patient compliance, and failure to identify early signs of decompensation.

Conclusion. These results identify multiple gaps over the spectrum of HF care, including, treatment, diagnosis (difficult access to echocardiography), treatment planning (underuse of recommended agents and subtherapeutic dosing), treatment monitoring and adjustment (lack of adherence to recommendations), and long-term management (difficulties to provide appropriate and comprehensive patient education). These data may help identify current areas of potential improvement in the management of patients with HF.

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