How well informed are general practitioners about management strategies to improve the prognosis of heart failure?

July 2006    Volume 13, Issue 4   Br J Cardiol 2006;13:297-300

Authors:
Archana Rao, John Walsh, David Gray

Heart failure is a common condition, characterised by poor prognosis. Despite evidence that effective treatment improves symptoms and prognosis, management remains sub-optimal. General practitioners (GPs) have a key role in the assessment and treatment of patients with heart failure. This study was designed to ascertain the knowledge and attitude of GPs towards the management of heart failure.

Anonymised questionnaires were sent to 355 GPs in the Nottingham area in May 2003 and 227 (64%) responded. The mean (standard deviation) age of respondents was 45 (7) years and they had been in general practice for 15 (7.6) years. The questionnaires found that 223/227 (98%) of GPs were aware that angiotensin- converting enzyme (ACE) inhibitors have been shown in clinical trials to reduce mortality in heart failure; 155/224 (69%) were aware that beta blockers reduced mortality in heart failure; 53/225 (23.3%) believed diuretics improved prognosis. Almost 60% routinely initiated ACE inhibitors but 26% expressed concerns about their side effects and so were less likely to initiate this treatment.

Most GPs seemed able to manage heart failure effectively and ACE inhibitor prescription for patients with chronic heart failure (CHF) is now well established within primary care. Knowledge and prescription rates for the remaining effective therapies remain low.

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