Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Heart failure (HF) is a significant global health concern.
• Understanding HF management in diverse healthcare systems is crucial for improving patient outcomes.
• China's large population and evolving healthcare landscape present unique challenges and opportunities in HF care.

Purpose of the Study:

• To delineate the clinical care pathways for heart failure (HF) patients in China.
• To analyze management and treatment patterns in Chinese HF patients.
• To investigate hospitalization trends among HF patients in China.

Main Methods:

• A cross-sectional survey involving 150 cardiologists and their consecutive heart failure (HF) patients.
• Data collection included cardiologist-completed patient record forms and patient self-completion questionnaires.
• Analysis of care pathways, diagnostic and treatment patterns, and hospitalizations for 1,500 HF patients.

Main Results:

• Most HF patients received care in urban, tier-2 and -3 hospitals, managed primarily by cardiologists.
• Guideline-recommended diagnostic test utilization was high.
• However, guideline-recommended double- and triple-combination therapy was administered to only 51% and 18% of patients, respectively.
• 20% of patients reported not being consulted on therapy choices.
• High concordance (≥80%) was observed in reporting side effects, though cardiologists tended to underreport them compared to patient reports.

Conclusions:

• Cardiologists predominantly manage heart failure (HF) in China, with high diagnostic test usage.
• A significant gap exists between guideline-recommended treatments and actual clinical practice for HF.
• Enhancing patient-cardiologist communication is vital for optimizing treatment decisions and managing side effects effectively.