Lehnbom Elin C, Bergkvist Anna C, Gränsbo Klas
Therapeutics Centre, St Vincent's Hospital, Darlinghurst, NSW, 2010, Australia.
Division of Pharmacokinetics and Drug Therapy, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
Pharm World Sci. 2009 Oct;31(5):572-579. doi: 10.1007/s11096-009-9305-0. Epub 2009 Jun 24.
The aim of this pilot study was to investigate cause(s) of heart failure (HF).
The emergency department and medical wards at Malmö University Hospital.
A cross sectional pilot study.
Comparison of compliance, comprehension and optimal treatment on a population basis between men and women, younger (< or =75 years) and elderly (>75 years) patients, and patients in different New York Heart Association (NYHA) classes, in order to assess if exacerbation could have been caused by any of these factors.
Of the 47 patients included, 60% reported high compliance, with significant differences between women and men, and between patients in NYHA class IV and patients in NYHA class III. Comprehension on self-care was poor. Only 30% weighed themselves regularly and 45% did not limit the amount of fluids. No more than 28% reported they would contact a health professional in the case of experiencing more symptoms. Suboptimal treatment was also found to be a great concern. The majority were treated with recommended agents, but had not achieved target dose as recommended in the guidelines.
This pilot study indicates suboptimal HF management of patients with HF prior to hospital admission due to HF exacerbation. A larger study is needed to assess the extent of the problem, and establish the need and nature of management improvement in different patient subgroups.
本试点研究旨在调查心力衰竭(HF)的病因。
马尔默大学医院急诊科和内科病房。
一项横断面试点研究。
在总体人群基础上,比较男性与女性、年龄较小(≤75岁)与年龄较大(>75岁)患者以及不同纽约心脏协会(NYHA)分级的患者在依从性、理解能力和最佳治疗方面的情况,以评估病情加重是否可能由这些因素中的任何一个引起。
在纳入的47例患者中,60%报告依从性较高,女性与男性之间以及NYHA IV级患者与NYHA III级患者之间存在显著差异。自我护理的理解能力较差。只有30%的患者定期称体重,45%的患者没有限制液体摄入量。不超过28%的患者报告在出现更多症状时会联系医疗专业人员。还发现治疗不充分是一个重大问题。大多数患者接受了推荐药物治疗,但未达到指南中推荐的目标剂量。
这项试点研究表明,因HF加重而入院前的HF患者管理欠佳。需要进行更大规模的研究来评估问题的严重程度,并确定不同患者亚组管理改进的必要性和性质。