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Undertreatment of congestive heart failure in an Australian setting
Citation
Boyles, PJ and Peterson, GM and Blease, MD and Vial, JH, Undertreatment of congestive heart failure in an Australian setting, Journal of Clinical Pharmacy and Therapeutics, 29, (1) pp. 15-22. ISSN 0269-4727 (2004) [Refereed Article]
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The definitive published version is available online at: http://onlinelibrary.wiley.com/
Official URL: http://onlinelibrary.wiley.com/
DOI: doi:10.1046/j.1365-2710.2003.00531.x
Abstract
Aim: Guidelines for the management of patients with chronic heart failure have undergone change in recent years, with â-blockers and spironolactone shown to reduce mortality when added to angiotensin converting enzyme (ACE) inhibitors, diuretics and digoxin. The aim of this study was to examine the therapeutic management of heart failure in patients admitted to Tasmania's three major public hospitals, with an assessment of the appropriateness of the therapy according to contemporary published guidelines.
Methods: An extensive range of clinical and demographic data was retrospectively extracted from the medical records of consecutive adult patients admitted to the medical wards of the hospitals with heart failure, either as a primary diagnosis or as a comorbidity, during a 6-month period in late 1999–early 2001.
Results: The 450 patients (57% females) had a mean age of 77·8 ± 10·2 years, and were being treated with a median of seven drugs on hospital admission. The percentages of patients being treated with the major drugs of interest were: ACE inhibitors (50%), â-blockers (22%), spironolactone (15%), digoxin (24%), loop diuretics (65%) and angiotensin-II receptor antagonists (8%). Almost 10% were taking a non-steroidal anti-inflammatory agent. Less than one-half the patients who were receiving an ACE inhibitor were taking a target dose for heart failure. There were no significant differences in the pattern of drug use between the three hospitals. Underuse of heart failure medications was most pronounced in women and elderly patients.
Conclusions: The data suggest that current guidelines for the treatment of heart failure are still not being reflected in clinical practice. The relatively low use of drugs shown to improve survival in heart failure is of concern and warrants educational intervention.
Item Details
Item Type: | Refereed Article |
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Keywords: | angiotensin converting enzyme inhibitors;â-blockers;congestive heart failure;drug therapy;spironolactone |
Research Division: | Biomedical and Clinical Sciences |
Research Group: | Cardiovascular medicine and haematology |
Research Field: | Cardiology (incl. cardiovascular diseases) |
Objective Division: | Health |
Objective Group: | Clinical health |
Objective Field: | Clinical health not elsewhere classified |
UTAS Author: | Boyles, PJ (Mr Peter Boyles) |
UTAS Author: | Peterson, GM (Professor Gregory Peterson) |
UTAS Author: | Vial, JH (Associate Professor Janet Vial) |
ID Code: | 30781 |
Year Published: | 2004 |
Web of Science® Times Cited: | 16 |
Deposited By: | Medicine |
Deposited On: | 2004-08-01 |
Last Modified: | 2011-05-24 |
Downloads: | 0 |
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