Document Detail


The care for chronic heart failure by general practitioners. Results from a clinical audit in Italy.
MedLine Citation:
PMID:  22998169     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: In Italian primary care, chronic heart failure (CHF) patients are mainly managed by general practitioners (GPs). However, there are few studies analysing CHF management challenges in primary care and identifying opportunities for improvement. Objectives: To describe CHF care as implemented by GPs in the Veneto Region and to identify opportunities for improvement. Methods: In 2008, using an audit process, 114 Venetian GPs analysed their electronic health records, identified CHF patients and collected clinical and care related information: prevalence, co-morbidity, caring conditions, diagnostic and therapeutic management, and hospitalization. After two training sessions, data on pharmacotherapy were analysed again in 2009. Results: The prevalence of CHF was 1.2% (95% CI: 1.1-1.3%). Diagnostic echocardiography was used in 57% of cases. At baseline, the proportions of patients that used specific medication were: diuretics 88%; angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) 77%, beta-blockers 46% and anti-aldosterone agents 32%. After two training sessions, the use of ACE inhibitors/ARB and beta-blockers increased to 80% and 56%, respectively. Renal failure, chronic obstructive pulmonary disease (COPD), diabetes mellitus and dementia were the most prevalent concomitant diseases, posing specific management problems. Half of the patients were generally visited at home; they were dependent on some kind of care given. Conclusion: In Veneto a large number of CHF patients are mainly managed by GPs. Further improvements are necessary to meet standards of care with regard to diagnosis, medication, follow-up and home care. The care situation affected hospitalization and the quality of follow-up visits.
Authors:
Maurizio Cancian; Alessandro Battaggia; Mario Celebrano; Francesco Del Zotti; Bruno Franco Novelletto; Raffaella Michieli; Mario Saugo; Michele Pellizzari; Roberto Toffanin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-24
Journal Detail:
Title:  The European journal of general practice     Volume:  -     ISSN:  1751-1402     ISO Abbreviation:  Eur J Gen Pract     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9513566     Medline TA:  Eur J Gen Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
S.I.M.G. Società Italiana di Medicina Generale, Scuola Veneta di Medicina Generale , Padua , Italy.
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