What does this research mean for the field?

Cardiologists exhibit significantly higher confidence in diagnosing left ventricular systolic dysfunction compared to general practitioners, who show much lower confidence in diagnosing heart failure with preserved ejection fraction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To explore changes in healthcare professionals' perceptions regarding heart failure diagnosis and management since 2003.

March 1, 2014BMJ OpenOpen Access

Barriers to accurate diagnosis and effective management of heart failure have not changed in the past 10 years: a qualitative study and national survey

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Heart Failure (n=514). Primary outcome: Confidence in diagnosing left ventricular systolic dysfunction (LVSD) and heart failure with preserved ejection fraction (HFpEF) by clinicians..

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Key result

Cardiologists report high confidence diagnosing LVSD while just 7% of GPs feel confident diagnosing HFpEF.

n=514

Key Points

To explore changes in healthcare professionals' perceptions regarding heart failure diagnosis and management since 2003.
Conducted focus groups in North East England with 56 participants using a phenomenological approach.
Administered a national online cross-sectional survey with 514 healthcare professionals.
Identified categories affecting heart failure diagnosis and management through thematic analysis.
Confidence in diagnosing left ventricular systolic dysfunction varied by profession: 95% of cardiologists to 32% of heart failure nurses.
Significantly lower confidence in diagnosing heart failure with preserved ejection fraction, ranging from 58% of cardiologists to 6% of heart failure nurses.
Only 5–35% of healthcare professionals used natriuretic peptides for diagnosis; reported guidance from clinical guidelines was inconsistent in utility.

Study Design

Type

Cross-Sectional (n=514)

Multicenter

Yes

Structured PICO

Population

494 healthcare professionals in the UK (salaried GPs, partner GPs, cardiologists, general physicians, and heart failure nurses) responding to a national online survey, informed by 56 focus group participants.

Outcome

Healthcare professionals' views, confidence levels, and practices regarding the diagnosis and management of heart failure (LVSD and HFpEF).

Despite guidelines, significant barriers and variations persist in heart failure diagnosis and management across different healthcare professional groups, particularly for HFpEF.

Limitations

Variable response rate (3.1%).
Low confidence levels among clinicians managing heart failure.
Lack of access to specific diagnostic tests.
Lower than expected response rate prevented meaningful analysis of differences between groups
Reasons for non-participation are unknown

Discussion

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Implication

Diagnostic confidence gaps in HFpEF among non-cardiologists may warrant targeted education; cross-sectional data leave open whether interventions improve diagnosis or outcomes.

Cite This Study

Hancock et al. (2014) conducted a cross-sectional in Heart Failure (n=514). Cardiologists exhibited 95% confidence in diagnosing left ventricular systolic dysfunction, compared to just 7% of general practitioners for heart failure with preserved ejection fraction.

synapsesocial.com/papers/6961956115d481f6dda30a94 https://doi.org/10.1136/bmjopen-2013-003866

Topics

Heart failure HFrEF treatment HFpEF management

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Implication

Diagnostic confidence gaps in HFpEF among non-cardiologists may warrant targeted education; cross-sectional data leave open whether interventions improve diagnosis or outcomes.

Barriers to accurate diagnosis and effective management of heart failure have not changed in the past 10 years: a qualitative study and national survey

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Barriers to accurate diagnosis and effective management of heart failure have not changed in the past 10 years: a qualitative study and national survey

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider