Key result
A Delphi survey of 26 Canadian experts identified WHO functional class, 6-minute walk distance, and hospitalization for right heart failure as the most important clinical parameters for IPAH.
Why the study?
What are the most important clinical and physical examination parameters to assess response to therapy in patients with idiopathic pulmonary arterial hypertension according to Canadian experts?
Cross-Sectional (n=26)
Yes
What are the most important clinical and physical examination parameters to assess response to therapy in patients with idiopathic pulmonary arterial hypertension according to Canadian experts?
Canadian pulmonary hypertension experts reached consensus that WHO functional class, 6-minute walk distance, and right heart failure hospitalizations are the most critical parameters for reassessing IPAH patients after therapy initiation.
May guide Canadian IPAH monitoring; leaves open prospective outcome validation.
BACKGROUND: Many treatment options are now available for patients with idiopathic pulmonary arterial hypertension (IPAH). Data regarding the optimal combination of therapies are lacking, as is consensus on how to assess response to therapy and when to change therapeutic regimens. OBJECTIVES: To gather the opinions of Canadian pulmonary hypertension (PH) experts regarding standard practice in the care of IPAH patients after therapy is initiated. METHODS: Canadian PH physicians were surveyed using short questionnaires to assess their opinions and practices in the care of IPAH patients. A Delphi forecasting approach was used to gain consensus among Canadian physicians on the most important clinical parameters to consider when assessing patients after the initiation of therapy. RESULTS: Twenty-six of 37 Canadian PH experts who were invited to participate completed the study. All endorsed the use of combination therapy for IPAH patients despite the lack of universal provincial coverage for this approach. By consensus, WHO functional class, 6 min walk distance and hospitalization for right heart failure were the most important clinical parameters. The most highly rated physical examination parameters were jugular venous pressure, peripheral edema, the presence of ascites and body weight. CONCLUSIONS: The overall approach to care of IPAH patients is similar across PH centres in Canada. A limited number of clinical and physical examination parameters were considered to be most important to reassess patients after therapy is initiated. These parameters, along with definition of threshold values, will facilitate the development of standard practice guidelines for IPAH patients in Canada.
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Borrie et al. (2011) conducted a cross-sectional in Idiopathic pulmonary arterial hypertension (n=26). Delphi forecasting survey was evaluated on Consensus on most important clinical parameters to assess response to therapy. A Delphi survey of 26 Canadian experts identified WHO functional class, 6-minute walk distance, and hospitalization for right heart failure as the most important clinical parameters for IPAH.
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