Mind the Gap: Mismatches Between Clinicians and Patients in Heart Failure Medication Management.
Cardiovasc Drugs Ther
; 32(1): 37-46, 2018 02.
Article
in En
| MEDLINE
| ID: mdl-29318439
ABSTRACT
PURPOSE:
Previous studies on the 'treatment gap' in patients with heart failure (HF) have focused either on prescribing or patients' adherence to prescribed treatment. This study sought to determine whether or not recent initiatives to close the gap have also minimised any mismatches between physicians' expectation of their patients' medications, medications in the patients' possession and their actual medication use.METHODS:
A cross-sectional observational survey was conducted from December 2015 to June 2016 in The Alfred Hospital HF clinic in Melbourne, Australia. Patients were invited to participate if they had chronic HF (NYHA class II to IV), were aged ≥ 60 years, had no history of HF related hospitalisation within the past 6 months and were prescribed at least two HF medications.RESULTS:
Of 123 eligible patients, 102 were recruited into the study. Beta-blockers, mineralocorticoid receptor antagonists, loop diuretics and statins were associated with the highest rates of mismatches of drugs and doses, ranging from 10 to 17%. Discrepancy of total daily doses was the most common type of mismatch. Overall, only 23.5% of the patients were taking the right drugs at the right doses as expected by their cardiologists/HF specialists.CONCLUSIONS:
Despite improved prescribers' adherence to guideline-directed medical therapy, there remain considerable mismatches between prescribers' expectation of patients' HF medications, medications in patients' possession and their actual medication use. Initiatives to improve this situation are urgently needed.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Practice Patterns, Physicians'
/
Cardiovascular Agents
/
Attitude of Health Personnel
/
Health Knowledge, Attitudes, Practice
/
Medication Therapy Management
/
Medication Adherence
/
Professional Practice Gaps
/
Heart Failure
Type of study:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Oceania
Language:
En
Journal:
Cardiovasc Drugs Ther
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
TERAPIA POR MEDICAMENTOS
Year:
2018
Document type:
Article
Affiliation country:
Australia