General physicians and the management of heart failure in an Argentine population

Area of Science:

• Cardiology
• Primary Care Medicine
• Health Services Research

Background:

• Heart failure (HF) management requires adherence to evidence-based guidelines.
• General physicians (GPs) play a crucial role in primary HF care.
• Assessing GP knowledge and practice in HF management is essential for improving patient outcomes.

Purpose of the Study:

• To evaluate the perceptions and actual practices of general physicians (GPs) in managing heart failure (HF) in Buenos Aires.
• To identify discrepancies between recommended HF management and clinical implementation by GPs.
• To assess the utilization of diagnostic tools and pharmacological therapies for HF by GPs.

Main Methods:

• A cross-sectional study conducted in Buenos Aires involving 29 randomly selected GPs and data from 220 HF patients.
• Utilized "perception survey" for knowledge assessment and "actual practice survey" for treatment evaluation.
• Reviewed patient records for diagnostic test utilization (ECG, chest radiograph, echocardiogram) and medication prescriptions (ACE inhibitors, beta-blockers).

Main Results:

• Echocardiograms were performed in only 67% of patients, and left ventricular ejection fraction was documented in 23%.
• Exercise tests and coronary angiograms were infrequently used (16% and 7%, respectively).
• Only 43% of patients received ACE inhibitors, 33% received beta-blockers, and 9% received both; 50% had uncontrolled hypertension.

Conclusions:

• Heart failure management by general physicians in Buenos Aires is suboptimal.
• There is a significant gap between recommended HF care and actual practice regarding diagnostic testing and pharmacotherapy.
• Interventions are needed to improve GPs' knowledge and implementation of evidence-based HF management strategies.