Why the study?
What are the current care pathways, management, and treatment patterns for patients with heart failure in China?
What are the current care pathways, management, and treatment patterns for patients with heart failure in China?
Despite high utilization of diagnostic tests, adherence to guideline-recommended combination medical therapy for heart failure in China remains low, highlighting a significant gap in optimal management.
Low guideline-directed HF therapy uptake in China signals need for better cardiologist-patient dialogue; leaves open barriers to optimization in real-world settings.
PURPOSE: The objective of this study was to describe the clinical care pathways, management and treatment patterns, and hospitalizations for patients with heart failure (HF) in China. SUBJECTS AND METHODS: A cross-sectional survey of cardiologists and their patients with HF was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Patients for whom a patient record form was completed were invited to complete a patient self-completion questionnaire. RESULTS: Most of the 1,500 patients (mean [SD] age 66 [10] years; 55% male) included in the study received care in tier-2 and -3 hospitals in large cities. Cardiologists were responsible for initial consultation, diagnosis, and treatment of patients with HF. The use of guideline-recommended diagnostics was high. However, guideline-recommended double- and triple-combination therapy was received by only 51% and 18% of patients, respectively. In total, 20% of patients with HF reported that they were not consulted on the choice of therapy. Concordance was high (≥80%) between matched cardiologist and patient pairs for the occurrence of side effects, while cardiologists more often under- than overreported the occurrence of side effects of treatment reported by patients. CONCLUSION: The management of HF was predominantly overseen by cardiologists. The use of diagnostic tests was high, but the use of guideline-recommended treatment was low in this population. Improved communication between patients and cardiologists is essential to optimize treatment decision making and to increase awareness of treatment side effects.
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Jackson et al. (2018) studied this question.
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