WEDNESDAY, Sept. 25, 2002 (HealthDayNews) -- A class of drugs proven to reduce the symptoms of heart failure is vastly under-prescribed by doctors, says a new survey.
Only 38 percent of heart failure patients who could benefit from the use of beta-blockers are getting them from their doctors, although 87 percent of the physicians know the drugs to be effective, the survey of 400 doctors in Pennsylvania found.
The results are part of an ongoing program called The Heart Failure Report Card, being conducted by the Jefferson Medical College of Thomas Jefferson University in Philadelphia and the University of Pittsburgh Medical Center (UPMC). A report on the survey is to be delivered today at the annual meeting of the Heart Failure Society of America in Boca Raton, Fla.
Thirty-four percent of the doctors surveyed were cardiologists, while the rest were internists and family doctors. Only 38 percent of their patients were receiving beta-blockers in conjunction with other medications to treat their heart failure. This is despite studies that have shown beta-blockers are effective in treating the condition.
This could be partly due to the specialty of the doctor, says Dr. Kenneth A. Brown, a cardiologist at the University of Vermont College of Medicine. Cardiologists might be more likely to prescribe them than internists or family practitioners. However, the survey didn't break down the prescriptions by medical specialty.
"If it's true that other specialties are under-prescribing the beta-blockers, they should re-evaluate their criteria because there is an established, clear benefit to their use," he says.
The rest of the survey, which asked doctors to rate the how well heart failure is being diagnosed and treated, paints a dim picture. Using a report card format to register their opinions, doctors' gave a "C" as to patient satisfaction with the efficacy of their medications and their quality of life, a "C-" to patients' compliance with medications, and a "D+" to the patients' compliance with lifestyle changes and understanding the seriousness of heart failure.
A second survey was conducted of 759 heart failure patients to assess their level of knowledge of their disease.
Over half of the patients did not understand what heart failure was when they were diagnosed, and even after diagnosis, more than one-third were still unable to clearly define the disease. Forty-six percent of them reported that their heart failure reduced their ability to lead a normal life. Sixty-one percent, however, did know their illness was related to another disease.
In addition, 27 percent reported that their doctors did not give them information about their heart failure, and 40 percent used magazines and newspapers to gather information about their disease.
Heart failure is an overall weakening of the heart so that it doesn't pump blood efficiently throughout the body, causing fatigue, shortness of breath and ankle and foot swelling. It usually ensues as a result of another health condition like a heart attack or high blood pressure, according to the National Institutes of Health (NIH).
The death rate from heart failure rose by 64 percent from 1970 to 1990, primarily due its prevalence in our aging population. It is the only major cardiovascular disease that is increasing in the population. Approximately 2 million Americans have heart failure, and 400,000 new cases are diagnosed each year, according to NIH.
A third survey in the Heart Failure Report Card consisted of telephone interviews with 1,000 adult Americans, chosen to represent a cross-section of the population. Nearly half of those interviewed, 47 percent, were unable to clearly define what heart failure was, 89 percent thought you could live a normal life with the disease, and over 90 percent of those interviewed believed that heart failure could be successfully managed by regular exercise, not smoking, changing diet and losing weight.
The researchers concluded the key to more successful treatment of heart failure is more knowledge.
"There is clearly a need for further education for heart failure patients regarding their disease and its treatments, and we need to also educate the physician as well as the patient. Patients need to realize they can improve the quality of their lives after diagnosis. It is not a death sentence," says Virginia Schneider, a research coordinator at University of Pittsburgh Medical Center and co-author of the survey.
What To Do
A thorough explanation of heart failure can be found at the National Institutes of Health. For further information about the survey and how to learn more about heart failure, go to the Heart Failure Report Card.
