A primary care heart failure service identified 2916 additional patients requiring LVSD codes (a 47% increase) and found 45% of reviewed patients required medication optimization.
Observational (n=19,393)
Yes
Does a primary care heart failure service identify missed patients with HF and LVSD and improve treatment optimization?
A primary care heart failure service utilizing clinical audits and cardiologist reviews can effectively identify missed patients with HF and LVSD, leading to significant increases in diagnostic coding, medication optimization, and device therapy eligibility.
AIMS: We explored whether a missed cohort of patients in the community with heart failure (HF) and left ventricular systolic dysfunction (LVSD) could be identified and receive treatment optimization through a primary care heart failure (PCHF) service. METHODS AND RESULTS: PCHF is a partnership between Inspira Health, National Health Service Cardiologists and Medtronic. The PCHF service uses retrospective clinical audit to identify patients requiring a prospective face-to-face consultation with a consultant cardiologist for clinical review of their HF management within primary care. The service is delivered via five phases: (i) system interrogation of general practitioner (GP) systems; (ii) clinical audit of medical records; (iii) patient invitation; (iv) consultant reviews; and (v) follow-up. A total of 78 GP practices (864 194 population) have participated. In total, 19 393 patients' records were audited. HF register was 9668 (prevalence 1.1%) with 6162 patients coded with LVSD (prevalence 0.7%). HF case finder identified 9725 additional patients to be audited of whom 2916 patients required LVSD codes adding to the patient medical record (47% increase in LVSD). Prevalence of HF with LVSD increased from 0.7% to 1.05%. A total of 662 patients were invited for consultant cardiologist review at their local GP practice. The service found that within primary care, 27% of HF patients identified for a cardiologist consultation were eligible for complex device therapy, 45% required medicines optimization, and 47% of patients audited required diagnosis codes adding to their GP record. CONCLUSION: A PCHF service can identify a missed cohort of patients with HF and LVSD, enabling the optimization of prognostic medication and an increase in device prescription.
Kahn et al. (Wed,) conducted a observational in Heart failure with left ventricular systolic dysfunction (n=19,393). Primary care heart failure (PCHF) service was evaluated on Identification of missed patients and treatment optimization needs. A primary care heart failure service identified 2916 additional patients requiring LVSD codes (a 47% increase) and found 45% of reviewed patients required medication optimization.