ASSESSMENT OF PHYSICIAN ADHERENCE TO GUIDELINE RECOMMENDED MEDICATION IN Heart failure WITH REDUCED Ejection fraction AT OUTPATIENT CARDIAC CLINIC; RETROSPECTIVE CROSS SECTIONAL STUDY AT BLACK LION SPECIALIZED HOSPITAL
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- Articles
- Submited: June 28, 2021
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Published: March 29, 2022
Abstract
Abstract
Background-Heart failure is a burden for health-care system. There is clear evidence from land-mark studies that optimal uses of ACEI, ARB, BB, and MRA with the aim of achieving target dose used in RCTs improves survival and reduce morbidity in patient with HF with reduced EF.
Objective of this study is to evaluate physicians’ adherence to guideline-recommended medications for the treatment of chronic heart failure (CHF) with reduced EF.
Method-Retrospective Cross-sectional study was conducted and a medical record of 364 patients with HFrEF treated at TASH from 2012 to 2018 was reviewed. GCA score was used to score use of ACEI, BB, ARB, and MRA according to international guideline. SPSS 20 software was used for data entry and analysis.
Result-GCA score was good in 36%, moderate in 47%, poor in 17% of the study patients. Class adherence for individual drug was 67% for ACEI, 48.7% for MRA, and 73.6% for Beta blockers. Proportion of patient at target dose (100%) was 7.6% for ACEI, 0.8% for Beta blockers and 1% for MRA. Use of more than 50% target dose was 36.7 % for ACEI, 6.6% for beta-blocker, 49% for MRA. Duration of heart failure > 5 years was associated with a good GCA(P=0.003). Diabetic patients were prescribed higher doses of ACEI, compared to non-diabetics (p=0.001).
Conclusion In these study use of all indicated medication was low (36%) and majority of patients were in less than 50% target dose, especially for beta-blocker and ACEI.
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