The in- and out-of-hospital management of HF patients: results from a nationwide Belgian survey. Issue 6 (3rd September 2021)

• Record Type: Journal Article
• Authors: Ghys, Liesbeth F.; Martens, Pieter; Heggermont, Ward A.; Gabriel, Laurence; Heyse, Alex; Troisfontaines, Pierre; Maris, Michael
• Is Part Of: Acta cardiologica. Volume 76:Issue 6(2021)
• Page Start: 632
• Page End: 641
• Publication Date: 2021-09-03
• Subjects: HFrEF -- survey -- multidisciplinary (treatment) -- HF nurse; Cardiology -- Periodicals; Cardiology; Cardiologie -- Périodiques; Cardiology; Cardiologie; Periodicals; Periodicals; 616.12005
• DOI: 10.1080/00015385.2020.1765105
• Languages: English
• ISSNs: 0001-5385

Abstract

Abstract: Background: We conducted a nationwide survey to describe the in-and out-of-hospital flow (diagnosis, treatment and follow-up) of patients with heart failure with reduced ejection fraction (HFrEF). Method: A survey was developed with five dedicated HF cardiologists. The data are all self-reported by cardiologists. Results: The response rate was 84%. Presence of a dedicated HF cardiologist or HF nurse was indicated by 49% and 46% of the hospitals respectively. Devices ( p < .05), angiotensin receptor neprilysin inhibitors, and rehabilitation are considered more standard of care therapy by dedicated compared to non-dedicated HF cardiologists. Most cardiologists indicated that target dosages of HF drugs can be reached in 25‒75% of patients. Achieving >75% of the target dose seems easier for angiotensin converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) (22%) and mineralocorticoid receptor antagonists (25%), compared to β-blockers (10%) and angiotensin receptor neprilysin inhibitors (7%). 62%, 49% and 4% of the cardiologists indicated to use subtypes of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and β-blockers respectively not validated in the HF population. In the acute setting, dedicated HF cardiologists (23%) are less influenced by blood parameters for decongestion compared to non-dedicated HF cardiologists (39%). They tend to change patients more to guideline-recommended drugs (60% vs 47%). Six minutes walk test and ergospirometry are significantly more used by dedicated compared to non-dedicated HF cardiologists for HF drug change (17% and 29% vs 2% and 4%). Conclusion: This survey showed that a minority of hospitals have HF care. Those that do, report a higher implementation of guideline-recommended diagnosis, treatment and follow-up of HF patients. Competent authorities could use this survey as a tool to improve HF care.