Vol 62, No 3 (2005)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
Get Citation

What primary care physicians know about diagnosis and treatment of chronic heart failure

Michał Wierzchowiecki, Kajetan Poprawski, Anna Nowicka, Magdalena Kandziora, Anna Piątkowska
Kardiol Pol 2005;62(3):223-228.
Vol 62, No 3 (2005)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: The majority of patients with chronic heart failure (CHF) are treated by primary care physicians. Recent studies have shown that their knowledge about diagnosis and treatment of CHF is not satisfactory.
Aim: To evaluate the knowledge of primary care physicians on the diagnosis and treatment of patients with CHF.
Methods: The survey consisting of 23 questions on the diagnosis and treatment of CHF, was filled in by 116 primary care physicians, practising in the city of Poznan´. The questions dealt with the most typical characteristics of CHF, including history, physical examination, diagnosis of diastolic CHF and medical treatment, according to the recent guidelines of the European Society of Cardiology.
Results: More than 90% of physicians regarded history and physical examination as the most important elements required for establishing the diagnosis of CHF. Ankle oedema, dyspnea and fatigue were listed as the most typical CHF symptoms. Almost 80% of surveyed physicians routinely performed ECG and chest radiogram in order to diagnose CHF. Echocardiography was used by only 20% of physicians, and the term "diastolic CHF" was familiar to only one third of them. Angiotensin converting enzyme inhibitors (ACEI) were used by more than two thirds of doctors, and beta-blockers - by one third. The correct initial recommended dose of enalapril was known to more than half of the physicians, and the target dose - to only one fourth of them. The correct initial recommended dose of carvedilol was known to almost half of the physicians, and the target dose - to only 3% of them. Diuretics were prescribed by 62% of physicians, spironolactone - by half of them, and digitalis - by one third of them.
Conclusions: Primary care physicians practising in the Poznań area diagnose CHF mainly on the basis of history, physical examination, ECG and chest radiogram. Echocardiography is underused which may hamper the accuracy of CHF diagnosis. ACEI and beta-blockers are also underused. These findings demonstrate that knowledge about diagnosis and treatment of CHF is insufficient among primary care physicians and indicate the need for educational and systematic changes, including a wider access to echocardiography.

Abstract

Background: The majority of patients with chronic heart failure (CHF) are treated by primary care physicians. Recent studies have shown that their knowledge about diagnosis and treatment of CHF is not satisfactory.
Aim: To evaluate the knowledge of primary care physicians on the diagnosis and treatment of patients with CHF.
Methods: The survey consisting of 23 questions on the diagnosis and treatment of CHF, was filled in by 116 primary care physicians, practising in the city of Poznan´. The questions dealt with the most typical characteristics of CHF, including history, physical examination, diagnosis of diastolic CHF and medical treatment, according to the recent guidelines of the European Society of Cardiology.
Results: More than 90% of physicians regarded history and physical examination as the most important elements required for establishing the diagnosis of CHF. Ankle oedema, dyspnea and fatigue were listed as the most typical CHF symptoms. Almost 80% of surveyed physicians routinely performed ECG and chest radiogram in order to diagnose CHF. Echocardiography was used by only 20% of physicians, and the term "diastolic CHF" was familiar to only one third of them. Angiotensin converting enzyme inhibitors (ACEI) were used by more than two thirds of doctors, and beta-blockers - by one third. The correct initial recommended dose of enalapril was known to more than half of the physicians, and the target dose - to only one fourth of them. The correct initial recommended dose of carvedilol was known to almost half of the physicians, and the target dose - to only 3% of them. Diuretics were prescribed by 62% of physicians, spironolactone - by half of them, and digitalis - by one third of them.
Conclusions: Primary care physicians practising in the Poznań area diagnose CHF mainly on the basis of history, physical examination, ECG and chest radiogram. Echocardiography is underused which may hamper the accuracy of CHF diagnosis. ACEI and beta-blockers are also underused. These findings demonstrate that knowledge about diagnosis and treatment of CHF is insufficient among primary care physicians and indicate the need for educational and systematic changes, including a wider access to echocardiography.
Get Citation

Keywords

chronic heart failure - diagnosis - treatment - primary care physicians

About this article
Title

What primary care physicians know about diagnosis and treatment of chronic heart failure

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 62, No 3 (2005)

Pages

223-228

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2005;62(3):223-228.

Keywords

chronic heart failure - diagnosis - treatment - primary care physicians

Authors

Michał Wierzchowiecki
Kajetan Poprawski
Anna Nowicka
Magdalena Kandziora
Anna Piątkowska

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl