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Titolo:
The barriers to effective management of heart failure in general practice
Autore:
Hickling, JA; Nazareth, I; Rogers, S;
Indirizzi:
Univ Coll London, Royal Free & Univ Coll Med Sch, Dept Primary Care & Populat Sci, Archway Resource Ctr, London N19 3UA, England Univ Coll London London England N19 3UA rce Ctr, London N19 3UA, England
Titolo Testata:
BRITISH JOURNAL OF GENERAL PRACTICE
fascicolo: 469, volume: 51, anno: 2001,
pagine: 615 - 618
SICI:
0960-1643(200108)51:469<615:TBTEMO>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONVERTING-ENZYME-INHIBITORS; PRACTITIONERS; DYSFUNCTION; PREVALENCE; CARE;
Keywords:
congestive heart failure; evidence-based guidelines; angiotensin-converting enzyme inhibitor; attitude of health personnel;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Hickling, JA Univ Coll London, Royal Free & Univ Coll Med Sch, Dept Primary Care & Populat Sci, Archway Resource Ctr, Holborn Union Bldg,Highgate Hill, London N193UA, England Univ Coll London Holborn Union Bldg,Highgate HillLondon England N19 3UA
Citazione:
J.A. Hickling et al., "The barriers to effective management of heart failure in general practice", BR J GEN PR, 51(469), 2001, pp. 615-618

Abstract

Background. Several studies have shown that most patients with heart failure are not investigated and treated according to published guidelines. Moreeffective management could reduce both mortality and morbidity from heart failure. Aim. To identify the reasons for gaps between recommended and actual management of heart failure in general practice. Design of study. A nominal group technique was used to elicit general practitioners' (GFs') perceptions of the reasons for differences between observed and recommended practice. Setting. Ten Medical Research Council General Practice Framework practicesin the North Thames region. Method. Data were collected on the investigation and treatment of failure in the 10 participating practices and presented to 49 GPs and 10 practice nurses from those practices. Results. Of the 674 patients requiring echocardiograms, 226 were referred for echocardiography (34%), and 183/391 (47%) with probable heart failure were prescribed angiotensin-converting enzyme inhibitors. A wide variety of barriers were elicited. The main barrier to the use of echocardiograms in the diagnosis of heart failure was lack of open access. The main barrier to the use of angiotensin-converting enzyme inhibitors in treating heart failure was GPs' concerns about their possible adverse effects. Conclusion. The barriers to the effective management of heart failure in general practice are complex. We recommend further research to establish whether multifaceted intervention programmes based on our findings can improvethe management of heart failure in primary care.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 13:40:23