Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?

Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?

Evidence-based heart failure management now includes beta-blockers and spironolactone in addition to diuretics and angiotensin-converting enzyme inhibitors. We aim to determine if these recommendations had been applied in practice for acute and chronic stable heart failure, and what difficulties the...

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Main Authors: Chin, S P, Sapari, Satwi, How, Soon Hin, Sim, K. H.
Format: Article
Language:English
Published: Malaysian Medical Association 2006
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/29431/
http://irep.iium.edu.my/29431/
http://irep.iium.edu.my/29431/1/Congestive_Heart_Failure.pdf
id iium-29431
recordtype eprints
spelling iium-294312013-04-16T07:52:48Z http://irep.iium.edu.my/29431/ Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence? Chin, S P Sapari, Satwi How, Soon Hin Sim, K. H. R Medicine (General) Evidence-based heart failure management now includes beta-blockers and spironolactone in addition to diuretics and angiotensin-converting enzyme inhibitors. We aim to determine if these recommendations had been applied in practice for acute and chronic stable heart failure, and what difficulties there might be. Data from 80 consecutive patients hospitalized for decompensated heart failure ('acute') between May and July 2003 were analyzed at admission, upon discharge and at 12 weeks follow-up; along with 74 cardiology clinic out-patients with stable congestive heart failure ('chronic'- no decompensation or admission in previous six months). Less than half of study patients with prior left ventricular dysfunction were on ACE-inhibitors (47%), diuretics (39%), ATII antagonists, spironolactone or digoxin (5% each). All 'acute' patients were commenced on diuretics and ACE-inhibitors in hospital. Six patients died or transferred to another center. Compliance with clinic appointment at 12 weeks was 85% despite telephone reminders. Drug prescription at 12 weeks was significantly lower for diuretics and ACE-inhibitors compared to prescription at discharge (all p < 0.05) but higher compared to patients with chronic HF. Diuretics and ACE inhibitors remain under-utilized for patients with recurrent heart failure. Use of spironolactone and beta-blocker is slow due to limited medical experience and funding. Clinic non-attendance is significant and due to patient factors. Malaysian Medical Association 2006-08 Article PeerReviewed application/pdf en http://irep.iium.edu.my/29431/1/Congestive_Heart_Failure.pdf Chin, S P and Sapari, Satwi and How, Soon Hin and Sim, K. H. (2006) Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence? The Medical Journal of Malaysia, 61 (3). pp. 278-83. ISSN 0300-5283 http://www.e-mjm.org/2006/v61n3/Congestive_Heart_Failure.pdf
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Chin, S P
Sapari, Satwi
How, Soon Hin
Sim, K. H.
Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?
description Evidence-based heart failure management now includes beta-blockers and spironolactone in addition to diuretics and angiotensin-converting enzyme inhibitors. We aim to determine if these recommendations had been applied in practice for acute and chronic stable heart failure, and what difficulties there might be. Data from 80 consecutive patients hospitalized for decompensated heart failure ('acute') between May and July 2003 were analyzed at admission, upon discharge and at 12 weeks follow-up; along with 74 cardiology clinic out-patients with stable congestive heart failure ('chronic'- no decompensation or admission in previous six months). Less than half of study patients with prior left ventricular dysfunction were on ACE-inhibitors (47%), diuretics (39%), ATII antagonists, spironolactone or digoxin (5% each). All 'acute' patients were commenced on diuretics and ACE-inhibitors in hospital. Six patients died or transferred to another center. Compliance with clinic appointment at 12 weeks was 85% despite telephone reminders. Drug prescription at 12 weeks was significantly lower for diuretics and ACE-inhibitors compared to prescription at discharge (all p < 0.05) but higher compared to patients with chronic HF. Diuretics and ACE inhibitors remain under-utilized for patients with recurrent heart failure. Use of spironolactone and beta-blocker is slow due to limited medical experience and funding. Clinic non-attendance is significant and due to patient factors.
format Article
author Chin, S P
Sapari, Satwi
How, Soon Hin
Sim, K. H.
author_facet Chin, S P
Sapari, Satwi
How, Soon Hin
Sim, K. H.
author_sort Chin, S P
title Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?
title_short Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?
title_full Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?
title_fullStr Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?
title_full_unstemmed Managing congestive heart failure in a general hospital in Malaysia. Are we keeping pace with evidence?
title_sort managing congestive heart failure in a general hospital in malaysia. are we keeping pace with evidence?
publisher Malaysian Medical Association
publishDate 2006
url http://irep.iium.edu.my/29431/
http://irep.iium.edu.my/29431/
http://irep.iium.edu.my/29431/1/Congestive_Heart_Failure.pdf
first_indexed 2023-09-18T20:43:12Z
last_indexed 2023-09-18T20:43:12Z
_version_ 1777409502606262272

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