A large-scale trial of captopril for mild to moderate heart failure in the primary care setting

1991 ◽  
Vol 14 (8) ◽  
pp. 676-682 ◽  
Author(s):  
Robert Dibianco,
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Large Scale ◽  
Care Setting ◽  
Primary Care Setting ◽  
Moderate Heart Failure

scholarly journals Palliative Care in a Death-Denying Culture: Exploring Barriers to Timely Palliative Efforts for Heart Failure Patients in the Primary Care Setting

2020 ◽  
Vol 38 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Rebecca M. Crimmins ◽  
Lydia Elliott ◽  
Darren T. Absher
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Palliative Care ◽  
Patient Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Cochrane Library ◽  
Care Providers ◽  
Communication Time

Context: Heart failure (HF) is a complex, life-limiting disease that is prevalent and burdensome. All major cardiology societies and international clinical practice guidelines recommend the integration of palliative care (PC) interventions alongside usual HF management. Objectives: The purpose of this review of the literature was to evaluate the various barriers to the early initiation of PC for HF patients in the primary care setting. Methods: An integrative literature review was conducted in order to assess and incorporate the diverse sources of literature available. An EBSCO search identified relevant articles in the following databases: Medline complete, Academic Search Premier, CINAHL, PsycINFO, Cochrane Library, and SocINDEX. The search was limited to full text, peer reviewed, English only, and published between 2010 and 2019. Results: Barriers to the integration of PC for HF patients include poor communication between provider/patient and interdisciplinary providers, the misperception and miseducation of what PC is and how it can be incorporated into patient care, the unpredictable disease trajectory of HF, and the limited time allowed for patient care in the primary care setting. Conclusion: The results of this review highlight a lack of communication, time, and knowledge as barriers to delivering PC. Primary care providers caring for patients with HF need to establish an Annual Heart Failure Review to meticulously evaluate symptoms and allow the time for communication involving prognosis, utilize a PC referral screening tool such as the Needs Assessment Tool: Progressive Disease-Heart Failure, and thoroughly understand the benefits and appropriate integration of PC.

scholarly journals The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods

2020 ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A Munro Neville ◽  
Ralph G Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Venous Pressure ◽  
Community Setting ◽  
Annual Incidence ◽  
Free Text ◽  
Australian Community

Abstract There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF. Methods : We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals. Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign. Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

scholarly journals The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods

2019 ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A Munro Neville ◽  
Ralph G Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Community Setting ◽  
Annual Incidence ◽  
Free Text ◽  
Novel Approach ◽  
Australian Community

Abstract Background: There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF. Methods: We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals. Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF. These estimates accord with findings in similar populations from other countries. Among ‘active patients’ (regular attenders of a practice), the crude prevalence of HF was 1.813% (95%CI:1.79–1.84%), and the age-standardised prevalence was 2.199% (95%CI:2.168-2.23%). The annual incidence was 0.291% (95%CI:0.286–0.296%), and the age-standardised annual incidence was 0.348% (95%CI:0.342–0.354%). The estimates of prevalence and incidence suggest that almost 420,000 people were living with HF in Australia in 2017, and over 66,000 new cases of HF occurred that year. Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

scholarly journals The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods

2020 ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A Munro Neville ◽  
Ralph G Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Venous Pressure ◽  
Community Setting ◽  
Annual Incidence ◽  
Free Text ◽  
Australian Community

Abstract Background: There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF.Methods: We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals.Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign.Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

scholarly journals The epidemiology of heart failure in the general Australian community - study of heart failure in the Australian primary carE setting (SHAPE): methods

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A. Munro Neville ◽  
Ralph G. Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Community Study ◽  
Australian Community

scholarly journals P4395Characteristics of patients with heart failure prescribed sacubitril/valsartan in the primary care setting in Germany

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
S. Klebs ◽  
B. Balas ◽  
S.S. Grunow ◽  
M. Schindler ◽  
J. Engelhard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Patients With Heart Failure

scholarly journals EARLY DETECTION OF MILD COGNITIVE IMPAIRMENT (MCI) IN PRIMARY CARE

2020 ◽  
pp. 1-6
Author(s):  
M.N. Sabbagh ◽  
M. Boada ◽  
S. Borson ◽  
M. Chilukuri ◽  
B. Dubois ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Large Scale ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cognitive Screening ◽  
Patient Journey ◽  
Cognitive Evaluation

Mild cognitive impairment (MCI) is significantly misdiagnosed in the primary care setting due to multi-dimensional frictions and barriers associated with evaluating individuals’ cognitive performance. To move toward large-scale cognitive screening, a global panel of clinicians and cognitive neuroscientists convened to elaborate on current challenges that hamper widespread cognitive performance assessment. This report summarizes a conceptual framework and provides guidance to clinical researchers and test developers and suppliers to inform ongoing refinement of cognitive evaluation. This perspective builds upon a previous article in this series, which outlined the rationale for and potentially against efforts to promote widespread detection of MCI. This working group acknowledges that cognitive screening by default is not recommended and proposes large-scale evaluation of individuals with a concern or interest in their cognitive performance. Such a strategy can increase the likelihood to timely and effective identification and management of MCI. The rising global incidence of AD demands innovation that will help alleviate the burden to healthcare systems when coupled with the potentially near-term approval of disease-modifying therapies. Additionally, we argue that adequate infrastructure, equipment, and resources urgently should be integrated in the primary care setting to optimize the patient journey and accommodate widespread cognitive evaluation.

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