Key result
At hospital discharge, heart failure patients were frequently prescribed diuretics (100%), ACEI/ARBs (63.7%), and MRAs (51.2%), but beta-blockers were significantly under-prescribed (15.6%).
Observational (n=494)
No
While diuretics and ACEI/ARBs were frequently prescribed at discharge for heart failure patients in Abidjan, beta-blockers remained significantly under-prescribed compared to ESC guidelines.
Highlights gaps in ESC guideline adherence at HF discharge; hypothesis-generating for quality improvement initiatives in similar settings.
Introduction: Understanding improvement of pathophysiology of heart failure has allowed therapeutic progress over the past two decades in the pathology management. Our patients should benefit from these new drugs that improve survival. Objective: To analyze the treatment of hospital discharge according to ESC (European Society of Cardiology) Guidelines. Methods: We carried out a retrospective and descriptive study which included completed survey of patients hospitalized for heart failure in Medicine Department of cardiology Institut of Abidjan between January 1st 2011 to December 31st 2012. We analyzed the drugs prescription during hospital discharge by using the register of hospitalization. Results: 92.9% of the 532 files retained were included. Patients had a mean age of 54.4 ± 16.4 years old. 36.3% of the cases had a heart failure history with an average of 5.7 ± 3.2 days of hospital stay. At the hospital discharge, patients had for prescription: a diuretic specially Furosemide (100%), angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB) (63.7%), a beta-blocker (17.9%) and a mineralocorticoids receptor antagonist (MRA) (51.2%). Diuretic, IEC or ARB and the MRA were prescribed systematically. Beta-blockers were lower prescribed to patients who showed no more signs of congestion. Conclusion: Our prescribing practices were adapted to the guidelines for heart failure management. However, the gaps will be corrected through sensitization and training.
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Bamba-Kamagaté et al. (2016) conducted an observational in Heart Failure (n=494). Heart failure medications at hospital discharge was evaluated on Prescription rates of guideline-directed medical therapy at hospital discharge. At hospital discharge, heart failure patients were frequently prescribed diuretics (100%), ACEI/ARBs (63.7%), and MRAs (51.2%), but beta-blockers were significantly under-prescribed (15.6%).
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