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心力衰竭患者的个体化护理:我们是否准备好迎来一场革命?来自两项国际调查的医疗保健专业人员需求和患者认知的见解。

Personalized care of patients with heart failure: are we ready for a REWOLUTION? Insights from two international surveys on healthcare professionals' needs and patients' perceptions.

机构信息

Institute of Heart Diseases, Wrocław Medical University, Wrocław, Poland.

Institute of Heart Diseases, University Hospital, Wrocław, Poland.

出版信息

Eur J Heart Fail. 2023 Mar;25(3):364-372. doi: 10.1002/ejhf.2798.

Abstract

AIMS

Guidelines for the management of heart failure (HF) are evolving, and increasing emphasis is placed on patient-centred care. As part of the REWOLUTION HF (REal WOrLd EdUcaTION in HF) programme, we conducted two international surveys aimed at assessing healthcare professionals' (HCPs) educational needs and patients' perspectives on the care of HF.

METHODS AND RESULTS

Anonymous online questionnaires co-developed by HF experts and patients assessed HCPs' educational needs (520 respondents, mostly cardiologists, in 67 countries) and patients' perceptions on HF impact and management (98 respondents in 18 countries). Among HCPs, 62.7% prioritized rapid initiation of all guideline-mandated medications over up-titration of some medications, and 87.7% always or frequently discussed treatment goals with patients. There was good agreement between HCPs and patients on key treatment goals, except for a greater emphasis on reducing hospitalizations among HCPs. The most frequently cited barriers to the provision of guideline-recommended pharmacological therapy were treatment side effects/intolerance, complex treatment regimens, low blood pressure, cost/reimbursement issues, and low estimated glomerular filtration rate. Most patients (81.6%) reported no difficulties taking medications as prescribed, although 21.4% felt they were taking too many pills. Patients wanted more information about HF and its consequences, prognosis, and treatments (70.4%, 74.5% and 76.6%, respectively). Cardiologists were the preferred source of information about HF, followed by general practitioners and HF nurses.

CONCLUSIONS

These surveys provide valuable insights into HCPs' needs about personalized care for patients with HF, as well as patients' perceptions, expectations and preferences. These findings will be helpful to develop patient-centred, needs-driven quality improvement programmes.

摘要

目的

心力衰竭(HF)管理指南不断发展,越来越强调以患者为中心的护理。作为 REWOLUTION HF(HF 的真实世界教育)计划的一部分,我们进行了两项国际调查,旨在评估医疗保健专业人员(HCP)的教育需求以及患者对 HF 护理的看法。

方法和结果

HF 专家和患者共同开发的匿名在线问卷评估了 HCP 的教育需求(来自 67 个国家的 520 名受访者,主要是心脏病专家)和患者对 HF 影响和管理的看法(来自 18 个国家的 98 名受访者)。在 HCP 中,62.7%优先快速启动所有指南规定的药物,而不是逐步增加一些药物的剂量,87.7%始终或经常与患者讨论治疗目标。HCP 和患者在关键治疗目标上有很好的一致性,但 HCP 更强调减少住院治疗。提供指南推荐的药物治疗的最常见障碍是治疗副作用/不耐受、复杂的治疗方案、低血压、成本/报销问题和估计肾小球滤过率低。尽管 21.4%的患者认为自己服用的药丸过多,但大多数患者(81.6%)报告按规定服用药物没有困难。患者希望获得更多关于 HF 及其后果、预后和治疗的信息(分别为 70.4%、74.5%和 76.6%)。心脏病专家是 HF 信息的首选来源,其次是全科医生和 HF 护士。

结论

这些调查为 HCP 提供了有价值的见解,了解他们对 HF 患者个性化护理的需求,以及患者的看法、期望和偏好。这些发现将有助于制定以患者为中心、需求驱动的质量改进计划。

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