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弥合中东地区和非洲心力衰竭认知、诊断与预防差距的战略建议。

Strategic Recommendations to Bridge the Gaps in Awareness, Diagnosis and Prevention of Heart Failure in the Middle East Region and Africa.

作者信息

Bennis Ahmed, Ogola Elijah N, Klug Eric, Skouri Hadi N, Al Saffar Hilal Bahjet, Ragy Hany, AlGhalayini Kamal Waheeb, Alhumood Khaldoon A, Abdelhamid Magdy, Yilmaz Mehmet Birhan, Tabbalat Ramzi, Çavuşoğlu Yüksel

机构信息

Department of Cardiology, Casablanca, Morocco.

University of Nairobi, Nairobiy, Kenya.

出版信息

J Saudi Heart Assoc. 2022 Apr 15;34(1):53-65. doi: 10.37616/2212-5043.1294. eCollection 2022.

Abstract

OBJECTIVE

With the increasing burden of heart failure (HF) in the Middle East Region and Africa (MEA), it is imperative to shift the focus to prevention and early detection of cardiovascular diseases. We present a broad consensus of the real-world challenges and strategic recommendations for optimising HF care in the MEA region.

METHOD

To bridge the gaps in awareness, prevention, and diagnosis of HF, an assembly of experts from MEA shared their collective opinions on the urgent unmet needs.

RESULTS

Lack of awareness in the community, high prevalence of risk factors, poor accessibility and affordability of care and diagnostics are the major barriers for delayed or missed diagnosis of HF in MEA. Enhancing patient awareness, through digital or social media campaigns, alongside raising knowledge of healthcare providers and policymakers with training programmes, can pave the way for influencing policy decisions and implementation of robust HF programmes. Multicountry registries can foster development of guidelines factoring in local challenges and roadblocks for HF care. Region-specific guidelines including simplified diagnostic algorithms can provide a blueprint of care for early detection of at-risk patients and facilitate efficient referral, thus mitigating clinician "therapeutic inertia." Multidisciplinary care teams and HF clinics with expanded role of nurses can streamline lifestyle modification and optimum control of dyslipidaemia, blood pressure, and glycaemia through guideline-recommended prevention therapies such as sodiumglucose co-transporter-2 inhibitors-thus supporting pleiotropic effects in high-risk populations.

CONCLUSION

Development of regional guidelines, enhancing awareness, leveraging digital technology, and commitment for adequate funding and reimbursement is pivotal for overcoming structural and health system-related barriers in the MEA region.

摘要

目的

随着中东和非洲地区心力衰竭(HF)负担的日益加重,将重点转向心血管疾病的预防和早期检测势在必行。我们针对中东和非洲地区优化心力衰竭护理的现实挑战和战略建议达成了广泛共识。

方法

为弥合心力衰竭在认知、预防和诊断方面的差距,来自中东和非洲地区的一组专家就迫切未得到满足的需求分享了他们的集体意见。

结果

社区缺乏认知、危险因素患病率高、护理和诊断的可及性及可负担性差,是中东和非洲地区心力衰竭诊断延迟或漏诊的主要障碍。通过数字或社交媒体宣传活动提高患者认知,同时通过培训计划提高医疗服务提供者和政策制定者的知识水平,可为影响政策决策和实施强有力的心力衰竭计划铺平道路。多国登记处可促进制定考虑到当地心力衰竭护理挑战和障碍的指南。包括简化诊断算法在内的针对特定区域的指南可为早期发现高危患者提供护理蓝图,并促进高效转诊,从而减轻临床医生的“治疗惰性”。多学科护理团队和护士作用扩大的心力衰竭诊所可通过钠-葡萄糖协同转运蛋白-2抑制剂等指南推荐的预防疗法,简化生活方式改变并优化血脂、血压和血糖控制,从而在高危人群中发挥多效作用。

结论

制定区域指南、提高认知、利用数字技术以及承诺提供充足资金和报销,对于克服中东和非洲地区与结构和卫生系统相关的障碍至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8514/9059727/7153fdc986e7/sha-53-65f1.jpg

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