Aws Almufleh1, Ricky D Turgeon2,3, Anique Ducharme4, Filio Billia5, Justin Ezekowitz6. 1. Department of Medicine, Division of Cardiology, Queen's University, Kingston, Ontario, Canada. 2. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada. 3. St. Paul's Hospital, Vancouver, British Columbia, Canada. 4. Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada. 5. Department of Medicine, Division of Cardiology, Peter Munk Cardiac Centre, University Health Network (UHN), Toronto, Ontario, Canada. 6. Mazankowski Alberta Heart Institute, Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Abstract
Background: The suboptimal implementation of guideline-directed medical therapy (GDMT) for heart failure (HF) patients has been linked with poor clinical outcomes. Little is known about the potential role of cardiology residency training programs in improving trainees' (ie, future cardiologists') ability to utilize GDMT. Methods: In this survey-based study, we examined the degree of exposure to ambulatory HF patient management among cardiology trainees in Canada. All cardiology residency program directors (n = 15; 100% response rate) completed our survey. Results: Although 9 programs (60%) mandated ≥ 3 ambulatory cardiology rotations, only 3 (20%) required ≥ 2 ambulatory HF rotations. When HF rotations were provided, only 7 programs (47%) offered moderate or higher exposure to ambulatory nontransplant HF patients (defined as ≥ 5 clinics/rotations). This element was independent of program- and institution-specific characteristics. All institutions had a multidisciplinary HF clinic, and the majority (13 [87%]) had access to an inpatient HF service, a consultative HF service, and/or a specialist pharmacist. Furthermore, 13 program directors (87%) agreed on the importance of adopting HF training curriculum and their program's readiness to implement such a module. Conclusions: The current state of HF training among cardiology residencies is suboptimal and in need of improvement. Most programs have access to a HF clinic, a specialist pharmacist, or an inpatient consultative service, which would facilitate adoption of a HF management curriculum that focuses on practical and experiential aspects of GDMT optimization. This program, which is under development, will be offered to training programs nationwide, to enable trainees to manage this growing and increasingly complex patient population.
Background: The suboptimal implementation of guideline-directed medical therapy (GDMT) for heart failure (HF) patients has been linked with poor clinical outcomes. Little is known about the potential role of cardiology residency training programs in improving trainees' (ie, future cardiologists') ability to utilize GDMT. Methods: In this survey-based study, we examined the degree of exposure to ambulatory HF patient management among cardiology trainees in Canada. All cardiology residency program directors (n = 15; 100% response rate) completed our survey. Results: Although 9 programs (60%) mandated ≥ 3 ambulatory cardiology rotations, only 3 (20%) required ≥ 2 ambulatory HF rotations. When HF rotations were provided, only 7 programs (47%) offered moderate or higher exposure to ambulatory nontransplant HF patients (defined as ≥ 5 clinics/rotations). This element was independent of program- and institution-specific characteristics. All institutions had a multidisciplinary HF clinic, and the majority (13 [87%]) had access to an inpatient HF service, a consultative HF service, and/or a specialist pharmacist. Furthermore, 13 program directors (87%) agreed on the importance of adopting HF training curriculum and their program's readiness to implement such a module. Conclusions: The current state of HF training among cardiology residencies is suboptimal and in need of improvement. Most programs have access to a HF clinic, a specialist pharmacist, or an inpatient consultative service, which would facilitate adoption of a HF management curriculum that focuses on practical and experiential aspects of GDMT optimization. This program, which is under development, will be offered to training programs nationwide, to enable trainees to manage this growing and increasingly complex patient population.
Authors: Wiley V Chan; Thomas A Pearson; Glen C Bennett; William C Cushman; Thomas A Gaziano; Paul N Gorman; Joel Handler; Harlan M Krumholz; Robert F Kushner; Thomas D MacKenzie; Ralph L Sacco; Sidney C Smith; Victor J Stevens; Barbara L Wells Journal: J Am Coll Cardiol Date: 2017-01-26 Impact factor: 24.094
Authors: Poghni A Peri-Okonny; Xiaojuan Mi; Yevgeniy Khariton; Krishna K Patel; Laine Thomas; Gregg C Fonarow; Puza P Sharma; Carol I Duffy; Nancy M Albert; Javed Butler; Adrian F Hernandez; Kevin McCague; Fredonia B Williams; Adam D DeVore; J Herbert Patterson; John A Spertus Journal: JACC Heart Fail Date: 2019-02-06 Impact factor: 12.035