The in- and out-of-hospital management of HF patients: results from a nationwide Belgian survey

L.F. Ghys*, P. Martens, W.A. Heggermont, L. Gabriel, A. Heyse, P. Troisfontaines, M. Maris

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background:We conducted a nationwide survey to describe the in-and out-of-hospital flow (diagnosis, treatment and follow-up) of patients with heart failure with reduced ejection fraction (HFrEF). Method:A survey was developed with five dedicated HF cardiologists. The data are all self-reported by cardiologists. Results:The response rate was 84%. Presence of a dedicated HF cardiologist or HF nurse was indicated by 49% and 46% of the hospitals respectively. Devices (p < .05), angiotensin receptor neprilysin inhibitors, and rehabilitation are considered more standard of care therapy by dedicated compared to non-dedicated HF cardiologists. Most cardiologists indicated that target dosages of HF drugs can be reached in 25-75% of patients. Achieving >75% of the target dose seems easier for angiotensin converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) (22%) and mineralocorticoid receptor antagonists (25%), compared to beta-blockers (10%) and angiotensin receptor neprilysin inhibitors (7%). 62%, 49% and 4% of the cardiologists indicated to use subtypes of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and beta-blockers respectively not validated in the HF population. In the acute setting, dedicated HF cardiologists (23%) are less influenced by blood parameters for decongestion compared to non-dedicated HF cardiologists (39%). They tend to change patients more to guideline-recommended drugs (60% vs 47%). Six minutes walk test and ergospirometry are significantly more used by dedicated compared to non-dedicated HF cardiologists for HF drug change (17% and 29% vs 2% and 4%). Conclusion:This survey showed that a minority of hospitals have HF care. Those that do, report a higher implementation of guideline-recommended diagnosis, treatment and follow-up of HF patients. Competent authorities could use this survey as a tool to improve HF care.
Original languageEnglish
Pages (from-to)632-641
Number of pages10
JournalActa Cardiologica
Volume76
Issue number6
Early online date5 Jun 2020
DOIs
Publication statusPublished - 3 Sep 2021

Keywords

  • care
  • congestion
  • death
  • disease
  • esc guidelines
  • eurobservational research-program
  • heart-failure pilot
  • hf nurse
  • hfref
  • intervention
  • multidisciplinary (treatment)
  • readmissions
  • strategies
  • survey
  • DEATH
  • HFrEF
  • CARE
  • STRATEGIES
  • HF nurse
  • EUROBSERVATIONAL RESEARCH-PROGRAM
  • INTERVENTION
  • CONGESTION
  • READMISSIONS
  • HEART-FAILURE PILOT
  • ESC GUIDELINES
  • DISEASE

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