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[Do West African cardiologists adhere to the guidelines for the management of heart failure ?]
Marie-Paule Bernadette N'cho-Mottoh1, Iklo Coulibaly1, Florent Koffi1
1Institut de cardiologie d'Abidjan, BPV 206, Abidjan, Côte d'Ivoire.
Insights
West African cardiologists showed moderate adherence to heart failure (HF) management guidelines. Improving access to cardiology journals and conference attendance can enhance guideline compliance for better patient outcomes.
Area of Science:
- Cardiology
- Public Health
Background:
- Adherence to heart failure (HF) management guidelines is crucial for reducing hospitalizations.
- Investigating guideline adherence among West African cardiologists is essential for improving HF care in the region.
Purpose of the Study:
- To assess the adherence of cardiologists in West Africa to current guidelines for managing heart failure.
- To identify factors influencing guideline compliance in this specific population.
Main Methods:
- A prospective, cross-sectional, multicentric study was conducted across Côte d'Ivoire, Togo, Benin, and Burkina-Faso.
- The "ADDress your Heart" online survey was used to collect data on cardiologists' adherence to HF management guidelines.
Main Results:
- 62.3% of 106 participating cardiologists reported close adherence to guidelines.
- Underutilization of key therapeutic classes was observed: mineralocorticoid receptor antagonists (57.5%), gliflozins (41.5%), and sacubitril-valsartan (30.1%).
- Affiliation with teaching hospitals, access to cardiology journals, and frequent conference attendance were significantly associated with higher guideline compliance.
Conclusions:
- Cardiologists in West Africa exhibit moderate adherence to heart failure management guidelines.
- While universal affiliation with university hospitals is challenging, promoting access to scientific journals and encouraging conference participation are actionable strategies to improve adherence.
Introduction:
Adherence to guidelines for the management of heart failure (HF) has been shown to be a strong predictor of reduced hospitalisations. The aim of this study was therefore to investigate the adherence of West African cardiologists to guidelines for the management of HF.
Methodology:
This was a prospective cross-sectional multicentric study (Côte d'Ivoire, Togo, Benin and Burkina-Faso). The "ADDress your Heart" survey developed was administered online to assess cardiologists' adherence to the guidelines for the management of heart failure.
Results:
62.3% of the 106 participants reported that they followed the guidelines closely. The therapeutic classes indicated as first-line by the latest guidelines were insufficiently suggested by physicians: 57.5% for mineralocorticoid receptor antagonists, 41.5% for gliflozins and 30.1% for sacubitril-valsartan In univariate logistic regression, affiliation with a teaching hospital OR [95% CI] = 3.0 [1.3-6.8], p < 0.01 ; access to scientific cardiology journals OR [95 % CI] = 3.4 [1.3-8.9], p = 0.01; and frequent attendance at conferences OR [95% CI]=1.8 [1.2-2.9], p < 0.01, were associated with guideline compliance. These factors persisted in multivariate analysis.
Conclusion:
Adherence of West African cardiologists to guidelines on the management of heart failure was moderate. If affiliation to a university hospital is difficult to apply to all cardiologists, access to scientific cardiology journals and frequent attendance in conference should be encouraged.
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