Current heart failure disease management and treatment in accredited units from Cardiology and Internal Medicine in Spain.
Rev Clin Esp 2023:S2254-8874(23)00074-7. [PMID:
37331594 DOI:
10.1016/j.rceng.2023.06.004]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/23/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND AND OBJECTIVES
Heart failure (HF) is a complex disease with high prevalence, incidence and mortality rates leading to high healthcare burden. In Spain, there are multidisciplinary HF units coordinated by Cardiology and Internal Medicine. Our objective is to describe its current organizational model and their adherence to the latest scientific recommendations.
MATERIALS AND METHODS
In late 2021, a scientific committee (with cardiology and internal medicine specialists) developed a questionnaire that was sent as an online survey to 110 H F units. 73 from cardiology (accredited by SEC-Excelente) and 37 from internal medicine, (integrated in UMIPIC program).
RESULTS
83 answers were received (75.5% total: 49 from cardiology and 34 from internal medicine). HF units are mostly integrated by specialists from cardiology, internal medicine and specialized nurse practitioners (34.9%). Patient characteristics from HF units are widely different when comparing those in cardiology to UMIPIC, being the latter older, more frequently with preserved ejection fraction and higher comorbidity burden. Most HF units (73.5%) currently use a hybrid face-to-face/virtual model to perform patient follow-up. Natriuretic peptides are the biomarkers most commonly used (90%). All four disease-modifying drug classes are mainly implemented at the same time (85%). Only 24% of HF units hold fluent communication with primary care.
CONCLUSIONS
Both models from Cardiology and Internal Medicine HF units are complementary, they include specialized nursing, they use hybrid approach for patient follow-up and they display a high adherence to the latest guideline recommendations. Coordination with primary care remains as the major improvement area.
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