Result card

  • CUR14: How is the disease or health condition currently managed according to published guidelines and in practice?
English

How is the disease or health condition currently managed according to published guidelines and in practice?

Authors: Ingrid Wilbacher, Nadine Berndt, Francesca Gillespie

Internal reviewers: Alessandra Lo Scalzo, Christian Vladescu, Christina Mototolea, Kristina Lampe, Maria Camerlingo

Basis search was not sufficient and a search (mainly on Medline) of all available guidelines in English was done. No quality assessment of guidelines was done. Focus was made on management indications within the reviewed guidelines.

The Global heart failure Awareness Programme {45} reports that despite clear recommendations regarding evidence-based medications, many patients with heart failure do not receive a prescription for potentially beneficial medication because they do not always comply with guidelines.

In the US more than a quarter of patients with heart failure did not receive an appropriate prescription and in Europe doses are often below those recommended {26},{28},{65}.

In Europe guidelines incorporate follow-up, monitoring  and support however about a quarter (7/26) of the countries reported having heart failure management programmes in more than 30 % ot their hospitals {49} and even when in place, they are not always used. In the US most hospital had fewer than half of 10 key recommended practices in place and fewer than 3 % had 10 in place {4}.

A recent Australian consensus statement {88} report that the management of chronic heart failure remains a pressing problem, with many apparent indicators of poor case detection, including discordant management with evidencebased treatment, recurrent hospital admission, and disconnected care issues these that are amplified among marginalised populations.

Tele-monitoring can be considered on add-on for the existing management options.

Global assessment

-Despite clear recommendations regarding evidence-based medications, many patients with heart failure do not receive a prescription for potentially beneficial medication because they do not always comply with guidelines {45}.

Europe

-In Europe prescription doses are often below those recommended {26},{28},{65};

-In Europe guidelines incorporate follow-up, monitoring  and support, however, about a quarter (7/26) of the countries reported having heart failure management programmes in more than 30 % ot their hospitals {49}  and even when in place, they are not always used.

USA

-In the US most hospital had fewer than half of 10 key recommended practices in place and fewer than 3 % had 10 in place {4};

-In the US more than a quarter of patients with heart failure did not receive an appropriate prescription {26},{28},{65}.

Australia

  • A recent Australian consensus statement {88} report that the management of chronic heart failure remains a pressing problem, with many apparent indicators of poor case detection, including discordant management with evidencebased treatment, recurrent hospital admission, and disconnected care issues these that are amplified among marginalised populations.

Important
Partially
Wilbacher I et al. Result Card CUR14 In: Wilbacher I et al. Health Problem and Current Use of the Technology In: Jefferson T, Cerbo M, Vicari N [eds.]. Structured telephone support (STS) for adult patients with chronic heart failure [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 16 June 2021]. Available from: http://corehta.info/ViewCover.aspx?id=305

References