Abstract

CHAVES, Walter Gabriel et al. Compliance with guidelines in inpatients with heart failure ¿Where are we?. Acta Med Colomb [online]. 2014, vol.39, n.1, pp.40-45. ISSN 0120-2448.

Abstract Heart failure is a highly prevalent disease with significant morbidity and mortality that generates large costs to the health system. Proper treatment is essential in order to obtain good clinical outcomes. The objective of this study is to assess the compliance with the pharmacological management of heart failure guidelines by the physician at hospital discharge. Methods: a descriptive , prospective study that included patients with decompensated heart failure admitted to the emergency department between December 2011 and February 2012. Data hospitalization and prescription at hospital discharge were collected. Two reviewers rated the prescription compliance of beta blockers (BB), angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blocker (ARB II) and spironolactone as recommended by the 2005 AHA guideline for heart failure - Update 2009. Indications and contraindications of each drug were considered. For BB, the type of BB prescribed was taken into account. Results: 47 patients were admitted. Mean age was 71 years (SD 14.3), with 55.3% female predominance. Five patients died, so the prescription was evaluated in 42 patients. Among these , 80.9% (34 /42) received BB, 76.1% (32 /42) ACE inhibitors or ARBs and 38% (16 /42) spironolactone. 19 patients had LVEF ≤ 40%. Compliance with the guidelines was adequate in 52.6% for BB, 77.7% for ACE inhibitors or ARBs and 78.5% for spironolactone. Conclusions: in this study, a compliance in guidelines recommendations for heart failure below of what is expected for the care of patients was found. The lower compliance was observed in prescribing beta blocker at discharge by a high metoprolol tartrate formulation. These data are consistent with studies realized in other countries and force to implement strategies of guidelines compliance to ensure that patients receive the appropriate treatment. (Acta Med Colomb 2014; 39: 40-45).

Keywords : heart failure; adhesion; beta blockers; angiotensin-converting enzyme inhibitor; management guidelines.

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