Magazine article Drug Topics

Docs Get Mediocre Score on Treatment of Heart Failure

Magazine article Drug Topics

Docs Get Mediocre Score on Treatment of Heart Failure

Article excerpt

A survey of 400 physicians found that thousands of heart failure patients are not receiving beta-blocker therapy, in spite of strong evidence that incorporating beta-blockers into a treatment plan increases survival and decreases the number of hospitalizations.

Survey respondents were asked to assign letter grades to questions on topics such as patient understanding of heart failure, compliance with the required lifestyle changes, physician satisfaction with available drug therapies, and the availability of education about treatment options. The nationwide survey, known as the Heart Failure Report Card, was conducted in conjunction with the Cardiovascular Institute of the University of Pittsburgh Medical Center (UPMC) Health System, with an educational grant from AstraZeneca.

The Heart Failure Report Card was developed in an attempt to understand the current beliefs and treatment patterns of physicians, according to Arthur Feldman, M.D., Ph.D., professor of medicine and director, Cardiovascular Institute of UPMC Health System, Pa. "The purpose of the survey was to try to obtain objective data about the perception of physicians regarding heart failure and to gain an understanding about their use of heart failure medications in their patients," explained Feldman. The survey was done, he continued, because both anecdotal reports and nondefinitive data indicate that beta-blocker usage was less than optimal.

Overall, heart failure diagnosis and treatment in the United States received the letter grade of C from the surveyed physicians. One of the most surprising findings was that although 87% of the physicians polled said that the benefits of beta-blocker therapy are clearly demonstrated in clinical trials, 62% of their patients are not receiving beta-blockers as part of their therapeutic regimen. Feldman sees this disparity as a complex problem. The first part of the issue is that patients must be educated about why they need to take (and pay for) yet another medication, when they may already be taking eight or nine other drugs.

Patient understanding of issues relevant to heart failure received the letter grade of D+. Respondents cited noncompliance with lifestyle changes and medications and a lack of understanding about what the medications do as the reasons for this abysmal grade. Feldman believes pharmacists can serve as an important educational resource for patients, by helping them understand the need for medication and what its benefits are and by encouraging them to become actively involved in their own care. …

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