Elin C Lehnbom1,2, Anna C Bergkvist3, Klas Gränsbo4. 1. Therapeutics Centre, St Vincent's Hospital, Darlinghurst, NSW, 2010, Australia. eleh5333@uni.sydney.edu.au. 2. Division of Pharmacokinetics and Drug Therapy, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden. eleh5333@uni.sydney.edu.au. 3. Hospital Pharmacy, University Hospital MAS, Malmö, Sweden. 4. Department of Internal Medicine, University Hospital MAS, Malmö, Sweden.
Abstract
OBJECTIVES: The aim of this pilot study was to investigate cause(s) of heart failure (HF). SETTING: The emergency department and medical wards at Malmö University Hospital. METHOD: A cross sectional pilot study. MAIN OUTCOME MEASURES: Comparison of compliance, comprehension and optimal treatment on a population basis between men and women, younger (< or =75 years) and elderly (>75 years) patients, and patients in different New York Heart Association (NYHA) classes, in order to assess if exacerbation could have been caused by any of these factors. RESULTS: Of the 47 patients included, 60% reported high compliance, with significant differences between women and men, and between patients in NYHA class IV and patients in NYHA class III. Comprehension on self-care was poor. Only 30% weighed themselves regularly and 45% did not limit the amount of fluids. No more than 28% reported they would contact a health professional in the case of experiencing more symptoms. Suboptimal treatment was also found to be a great concern. The majority were treated with recommended agents, but had not achieved target dose as recommended in the guidelines. CONCLUSION: This pilot study indicates suboptimal HF management of patients with HF prior to hospital admission due to HF exacerbation. A larger study is needed to assess the extent of the problem, and establish the need and nature of management improvement in different patient subgroups.
OBJECTIVES: The aim of this pilot study was to investigate cause(s) of heart failure (HF). SETTING: The emergency department and medical wards at Malmö University Hospital. METHOD: A cross sectional pilot study. MAIN OUTCOME MEASURES: Comparison of compliance, comprehension and optimal treatment on a population basis between men and women, younger (< or =75 years) and elderly (>75 years) patients, and patients in different New York Heart Association (NYHA) classes, in order to assess if exacerbation could have been caused by any of these factors. RESULTS: Of the 47 patients included, 60% reported high compliance, with significant differences between women and men, and between patients in NYHA class IV and patients in NYHA class III. Comprehension on self-care was poor. Only 30% weighed themselves regularly and 45% did not limit the amount of fluids. No more than 28% reported they would contact a health professional in the case of experiencing more symptoms. Suboptimal treatment was also found to be a great concern. The majority were treated with recommended agents, but had not achieved target dose as recommended in the guidelines. CONCLUSION: This pilot study indicates suboptimal HF management of patients with HF prior to hospital admission due to HF exacerbation. A larger study is needed to assess the extent of the problem, and establish the need and nature of management improvement in different patient subgroups.
Authors: Lisa G Pont; Wiek H van Gilst; Dirk J A Lok; Hans J A Kragten; Flora M Haaijer-Ruskamp Journal: Eur J Heart Fail Date: 2003-03 Impact factor: 15.534
Authors: Kenneth Dickstein; Alain Cohen-Solal; Gerasimos Filippatos; John J V McMurray; Piotr Ponikowski; Philip Alexander Poole-Wilson; Anna Strömberg; Dirk J van Veldhuisen; Dan Atar; Arno W Hoes; Andre Keren; Alexandre Mebazaa; Markku Nieminen; Silvia Giuliana Priori; Karl Swedberg Journal: Eur Heart J Date: 2008-09-17 Impact factor: 29.983