An audit of specialist nurse pharmacological intervention in chronic heart failure

Aim: Chronic heart failure (CHF) is a complex clinical syndrome associated with recurrent hospitalizations and high mortality. Evidence suggests that many patients are not receiving effective pharmacotherapy. The aim of this retrospective audit was to formally describe and evaluate the pharmacotherapy of an established heart failure nurse led clinic in North West London. Methods: A retrospective audit was undertaken in January 2007 on all patients diagnosed with CHF attending the out-patient nursing clinic between October and December 2006. Descriptive statistics were used to summarise patient data. Results: 77 patient letters were audited. Mean age 73 years (SD ± 13), with 32 patients (42%) female and 14 (18%) South Asian. ACE inhibitors were prescribed in 60 (78%) patients, with beta blockers and loop diuretics prescribed in 47 (61%) and 71 (92%) respectively. No statistically significant difference was found in prescription rates between male and female patients. A statistical significant difference (P=0.043) was observed in the age of patients prescribed aldosterone antagonists. Conclusions: Demographic data is consistent with survey evidence from the EuroHeart failure surveys (EHFS) and ADHERE registries and is appropriate to the local population. Pharmacological prescription rates are comparable with national and international survey standards and adhere to the European Society of Cardiology (ESC) guidelines.