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Awareness and perception of heart failure among European cardiologists, internists, geriatricians, and primary care
Willem J Remme1, John J V McMurray, F D Richard Hobbs
1Sticares Cardiovascular Research Foundation, PO Box 882, 3160 AB Rhoon, The Netherlands. w.j.remme@sticares.org
European Heart Journal
|May 29, 2008
Summary
Cardiologists demonstrate better adherence to heart failure (HF) management guidelines than internists, geriatricians, and primary care physicians. Educational initiatives are needed to improve HF care among non-specialists.
Area of Science:
- Cardiology
- Internal Medicine
- Geriatrics
- Primary Care
Background:
- Heart failure (HF) management guidelines exist to optimize patient outcomes.
- Awareness and adherence to these recommendations may vary across different medical specialties.
Purpose of the Study:
- To assess the awareness of HF management recommendations among cardiologists, internists/geriatricians, and primary care physicians in Europe.
- To identify disparities in the application of HF diagnosis and treatment strategies across these physician groups.
Main Methods:
- A survey was conducted among 2041 cardiologists, 1881 internists/geriatricians, and 2965 primary care physicians across nine European countries.
- A 32-item questionnaire assessed knowledge and practice patterns related to the diagnosis and treatment of HF (left ventricular ejection fraction <40%).
Main Results:
- Cardiologists showed higher utilization of echocardiography and echo-Doppler for diagnosis compared to internists/geriatricians.
- Internists/geriatricians and primary care physicians demonstrated lower rates of prescribing guideline-recommended medications like angiotensin-converting enzyme (ACE)-inhibitors and beta-blockers at target doses.
- A significant proportion of primary care physicians and internists/geriatricians relied on signs and symptoms for HF diagnosis and were less likely to initiate beta-blockers or add spironolactone in specific HF scenarios.
Conclusions:
- Adherence to guideline-recommended HF management strategies is suboptimal across all surveyed physician groups.
- Internists, geriatricians, and primary care physicians exhibit significantly lower adherence compared to cardiologists.
- There is a clear need for targeted educational programs to enhance the understanding and implementation of evidence-based HF care among non-specialist physicians.
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