Research Identifies Barriers to Heart Failure Treatment
Improving doctors' application of evidence-based research is essential if the treatment of heart failure is to improve, according to research published in the latest edition of The Medical Journal of Australia.
The article argues that there are significant gaps between best practice and current practice, caused by 'barriers' that impede the application of research findings and best practice guidelines in the primary care setting.
Authors Dr Susan Phillips, Dr Richard Marton and Prof Geoffrey Tofler say the main barriers are related to general practitioners' need for more information on the benefits of new tests and drugs, and for practical information on initiating and optimising complex therapies.
"GPs are inundated with treatment guidelines, and greater attention needs to be paid to providing information on how to implement them," Dr Phillips said.
"External factors such as access to treatment services and patient issues such as age, mobility, cost and patient willingness to comply with treatment, also affect the implementation of best practice.
"In addition, the treatment of heart failure is made more difficult by non-specific symptoms that may be masked by other medical conditions," Dr Phillips said.
The research identified many barriers in heart failure practice, suggesting that different approaches are needed to bridge the gap between evidence and best practice.
The research identified the main areas for improvement as being:
- Improved access to and understanding of echocardiography in confirming diagnosis and determining the cause of heart failure.
- More information on when and how to use medication such as ACE inhibitors and beta blockers.
- Instruction on how to avoid risk of medication side effects.
- Improving links between general practitioner and specialists.
Heart failure affects more than 300,000 Australians and is becoming increasingly common.
By understanding the barriers to effectively treating heart failure, strategies can be developed to improve implementation of best practice and therefore to improve the care of heart failure patients. The research is one element of the National Institute of Clinical Studies' Heart Failure Program.
The Medical Journal of Australia is a publication of the Australian Medical Association.