Author/Editor		Lainščak, Mitja; Keber, Irena
Title		Primary care physicians beliefs concerning heart failure management: results of a cross-sectional survey
Translated title		Prepričanja zdravnikov na primarni ravni o obravnavi srčnega popuščanja: rezultati presečne raziskave
Type		članek
Source		Slov Kardiol
Vol. and No.		Letnik 3, št. 2
Publication year		2006
Volume		str. 96-101
Language		eng
Abstract		Chronic heart failure (CHF) presents a growing challenge for general practitioners (GP). Sufficient evidence exists for diagnostic assessment and implementation of key therapies in patients with left ventricular systolic dysfunction. We aimed to assess beliefs about CHF management strategies among GP's in north-eastern Slovenia. In this cross sectional survey, 66 GP's from the Pomurje region were sent a structured questionnaire about their beliefs on CHF management. The completed questionnaire was returned by 35 GP's (53%). Most of the GP's would suspect heart failure in a patient presenting with typical symptoms and signs. Electrocardiogram (91%) was most frequently reported as a diagnostic procedure in a patient with suspicion of heart failure. In addition, 80% of GP's would refer many or all such patients for an echocardiography. The recognition of the brain natriuretic peptide was far less solid as only 37% of the GP's recognized the role of the serum level of BNP in the diagnosis of heart failure. Non-pharmacological measures would usually encompass general advice, whereas advice on physical activity, influenza vaccination, and avoidance of non-steroidal anti-inflammatory drugs would generally be neglected. Treatment with angiotensin converting enzyme inhibitors and diuretics is frequently considered by GP's. On the other hand, the use and up-titration of beta blockers and spironolactone would be considered in less than 50% of their CHF patients. A considerable gap between the guidelines and GP beliefs on the management of CHF exists. Systematic education of GP's should be encouraged.
Summary		Kronično srčno popuščanje (KSP) predstavlja pomemben izziv za zdravnike na primarni ravni. Diagnostična obravnava in zdravljenje bolnikov s sistolično disfunkcijo levega prekata temelji na rezultatih številnih raziskav. Z našo raziskavo smo želeli dobiti podatke o prepričanjih zdravnikov primarne ravni iz severovzhodne Slovenije o obravnavi bolnikov s KSF. V naši presečni raziskavi smo 66 zdravnikom primarne ravni v Pomurju poslali strukturiran vprašalnik o njihovih prepričanjih glede obravnave KSP. Izpolnjen vprašalnik je vrnilo 35 (53%) anketirancev. Večina bi na srčno popuščanje pomislila pri bolnikih z značilnimi simptomi in znaki in pri večini bolnikov (91%) bi zdravniki opravili elektrokardiogram. 80% zdravnikov bi večino ali vse take bolnike napotili na ultrazvočno preiskavo srca. Vlogo možganskega natriuretičnega peptida v diagnostiki srčnega popuščanja je poznalo 37% zdravnikov. Nefarmakološki ukrepi bi večinoma obsegali splošna navodila, medtem ko bi bili nasveti o telesni aktivnosti, cepljenju proti gripi in izogibanju nesteroidnih antirevmatikov manj pogosti. Zdravniki bi se večinoma odločili za zdravljenje z zaviralci angiotenzinske konvertaze in diuretiki, medtem ko bi se za uporabo in višanje odmerka beta blokatrojev in spironolaktona odločili pri manj kot polovici svojih bolnikov s KSP. Obstaja pomemben razkorak med smernicami in prepričanji zdravnikov primarne ravni glede obravnave KSP. Spodbujati je potrebno sistematično izobraževanje zdravnikov na primarni ravni.
Descriptors		HEART FAILURE, CONGESTIVE PRIMARY HEALTH CARE QUESTIONNAIRES