Dataset Information

Chronic heart failure management in primary healthcare in Poland: Results of a nationwide cross-sectional study.

ABSTRACT: Organizational and educational activities in primary care in Poland have been introduced to improve the chronic heart failure (CHF) management.To assess the use of diagnostic procedures, pharmacotherapy and referrals of CHF in primary care in Poland.The cross-sectional survey was conducted in 2013, involving 390 primary care centres randomly selected from a national database. Trained nurses contacted primary care physicians who retrospectively filled out the study questionnaires on the previous year's CHF management in the last five patients who had recently visited their office. The data on diagnostic and treatment procedures were collected.The mean age?±?SD of the 2006 patients was 72?±?11 years, 45% were female, and 56% had left ventricular ejection fraction <50%. The percentage of the CHF patients diagnosed based on echocardiography was 67% and significantly increased during the last decade. Echocardiography was still less frequently performed in older patients (?80 years) than in the younger ones (respectively 50% versus 72%, ??<0.001) and in women than in men (62% versus 71%, P?<0.001). The percentage of the patients treated with ?-blocker alone was 88%, but those with a combination of angiotensin inhibition 71%. The decade before, these percentages were 68% and 57%, respectively. Moreover, an age-related gap observed in the use of the above-mentioned therapy has disappeared.The use of echocardiography in CHF diagnostics has significantly improved in primary care in Poland but a noticeable inequality in the geriatric patients and women remains. Most CHF patients received drug classes in accordance with guidelines.

SUBMITTER: Wizner B

PROVIDER: S-EPMC5774260 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Chronic heart failure management in primary healthcare in Poland: Results of a nationwide cross-sectional study.

Wizner Barbara B Fedyk-Łukasik Małgorzata M Opolski Grzegorz G Zdrojewski Tomasz T Windak Adam A Czech Marcin M Dubiel Jacek S JS Marchel Michał M Rewiuk Krzysztof K Rywik Tomasz T Korewicki Jerzy J Grodzicki Tomasz T

The European journal of general practice 20171122 1

<h4>Background</h4>Organizational and educational activities in primary care in Poland have been introduced to improve the chronic heart failure (CHF) management.<h4>Objectives</h4>To assess the use of diagnostic procedures, pharmacotherapy and referrals of CHF in primary care in Poland.<h4>Methods</h4>The cross-sectional survey was conducted in 2013, involving 390 primary care centres randomly selected from a national database. Trained nurses contacted primary care physicians who retrospectivel ...[more]

PMID: 29164946

Similar Datasets

Project description:BackgroundCurrent international guidelines on dyslipidemia are not concordant on various aspects of management. Also, there are no uniformly accepted Indian guidelines. We, therefore, performed a physician survey to understand lipid management practices in India.MethodsAn anonymous survey questionnaire was administered to gauge physicians' self-reported behavior regarding lipid management aspects. Results were expressed in terms of percentages based on the number of responses obtained.ResultsA total of 404 physicians participated in the survey. Eighty-eight percent respondents ordered a lipid profile before starting statin therapy, and 80% preferred to set lipid targets, though the tools used for calculating cardiovascular risk varied. Atorvastatin was preferred over rosuvastatin in primary prevention (72.9 vs. 32.4%), secondary prevention (54.6 vs. 46.7%), diabetic patients (56.3 vs. 40.3%) and post-ACS (78.3 vs. 34%). High-intensity statins were preferred by 73.7% of respondents in post-ACS cases. Fifty percent doctors chose not to use a statin in diabetic patients, irrespective of their LDL-C levels. The most preferred drug option for managing atherogenic dyslipidemia and moderate hypertriglyceridemia was statin-fibrate combination (55.1%) and fibrates (35.4%), respectively. Sixty-three percent doctors preferred to prescribe statins in patients with moderately high LDL-C and normal triglycerides, without CHD or CHD risk equivalents. Around 28% of doctors preferred not to use pharmacotherapy for managing isolated low HDL. Of the participants, 73% used fibrates in ?20% of their dyslipidemic patients, with fenofibrate being the most preferred (90.5%). Ezetimibe was mainly used in patients with uncontrolled LDL-C despite statin therapy (52.4% respondents). Most preferred approaches to manage statin intolerance included reducing statin dose (39%) and stopping and restarting statins at a lower dose (34.5%). Fifty-two percent of doctors chose not to alter pre-existing therapy in patients who had LDL-C levels at goal but elevated non-HDL-C levels.ConclusionThis is the first survey in India that provides useful insights into Indian physicians' self-reported perspectives on managing dyslipidemia in routine clinical practice. Despite concordance with the currently available guidelines in certain aspects, there is incongruence in managing specific dyslipidemia problems. Further continuing medical education and the development of evidence-based, India-specific lipid guidelines can help reduce some of these differences.

Dataset Information

Chronic heart failure management in primary healthcare in Poland: Results of a nationwide cross-sectional study.

Publications

Chronic heart failure management in primary healthcare in Poland: Results of a nationwide cross-sectional study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets