Burgos Lucrecia M, Duczynski María P, Coronel María L, Thierer Jorge
Heart Failure, Pulmonary Hypertension, and Transplant Service, Instituto Cardiovascular de Buenos Aires, Buenos Aires.
Cardiology Department, Fundación Favaloro, Buenos Aires.
Arch Cardiol Mex. 2025;95(3):169-174. doi: 10.24875/ACM.24000111.
The implementation of heart failure (HF) guidelines in actual practice is rarely adequate and most patients do not receive optimal treatments. Our aim was to assess changes in attitudes, knowledge, confidence, and care pathways of HF patients among physicians in Argentina after a structured educational intervention.
Cross-sectional survey in 22 public and private health centers of physicians who participated in a comprehensive multi-module educational program (patient identification, classification/therapeutic options in advanced HF, structure/organization of the HF Day Hospital, education of patients in different stages/scenarios, and education of nursing staff in the management of patients at different stages/scenarios). Simple evidence-based roadmaps were created to address knowledge gaps.
The intervention improved physicians' confidence in the diagnosis of HF with preserved ejection fraction (p < 0.001), and prioritization of quadruple therapy for outpatients (p = 0.01) and patients with acute HF (p < 0.001). The proportion of "confident"/"very confident" physicians in identifying HF patients with reduced ejection fraction who could benefit from an implantable cardioverter-defibrillator increased significantly (p = 0.01), as did the relevance of hypertonic saline administration and intravenous iron infusions. The use of discharge checklists increased significantly after the intervention.
This multifaceted, structured intervention was effective in improving physicians' confidence and attitudes, as well as their knowledge and care pathways of HF patients in Argentina.
心力衰竭（HF）指南在实际临床实践中的实施情况很少能达到理想状态，大多数患者并未接受最佳治疗。我们的目的是评估在阿根廷，经过结构化教育干预后，医生对HF患者的态度、知识、信心及护理路径的变化。
对参与一个全面多模块教育项目（患者识别、晚期HF的分类/治疗选择、HF日间医院的结构/组织、不同阶段/场景下患者的教育以及不同阶段/场景下患者管理中护理人员的教育）的22家公立和私立医疗中心的医生进行横断面调查。创建了基于简单证据的路线图以弥补知识差距。
干预提高了医生对射血分数保留的HF诊断的信心（p<0.001），以及对门诊患者（p=0.01）和急性HF患者（p<0.001）进行四重治疗的优先级。在识别可从植入式心脏复律除颤器中获益的射血分数降低的HF患者方面，“有信心”/“非常有信心”的医生比例显著增加（p=0.01），高渗盐水给药和静脉注射铁剂的相关性也是如此。干预后出院检查表的使用显著增加。
这种多方面的结构化干预有效地提高了阿根廷医生对HF患者的信心和态度，以及他们的知识和护理路径。
