Adherence to clinical guidelines in heart failure (HF) outpatients: Impact of an interprofessional HF team on evidence-based medication use.
J Interprof Care
; 29(5): 483-7, 2015.
Article
em En
| MEDLINE
| ID: mdl-26091371
ABSTRACT
Clinical systolic heart failure (HF) guidelines specify recommendations for ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), and beta blockers according to doses used in clinical trials. However, many HF patients remain suboptimally treated. We sought to determine which provider type, between an interprofessional HF team, non-HF cardiologists, and primary care physicians (PCP), most optimally manages HF medications and doses. A retrospective chart review was performed on adult patients at an academic county hospital with an ejection fraction ≤40% and a diagnosis of HF, seen by a single provider type (HF team, cardiologist, or PCP) at least twice within a 12-month period. Utilization rates of any ACEI/ARB and any beta blocker were robust across provider types, though evidence-based ACEI/ARB and beta blocker were greatest from the HF team. Doses of evidence-based therapies dropped markedly in the non-HF team groups. The percent of patients prescribed optimal doses of an evidence-based ACEI/ARB AND beta blocker was 69%, 33%, and 25% for the HF team, cardiologists and PCPs, respectively (p < 0.0167). Patients followed by the HF team were more frequently prescribed evidence-based medications at optimal doses. This supports using specialized interprofessional HF teams to attain greater adherence to evidence-based recommendations in treating systolic HF.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pacientes Ambulatoriais
/
Inibidores da Enzima Conversora de Angiotensina
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Antagonistas Adrenérgicos beta
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Fidelidade a Diretrizes
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Antagonistas de Receptores de Angiotensina
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Insuficiência Cardíaca
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Relações Interprofissionais
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Interprof Care
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos