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Study: Delivery of heart-failure care needs improvement

Physician Practice Advisor, March 24, 2005

Only 32% of hospitalized heart-failure patients received recommended discharge instructions on diet, exercise, and medication management, and less than half received smoking-cessation counseling, according to an observational study recently published in the American Heart Journal.

The study-carried out by the world's largest heart failure registry, ADHERE(R) (Acute Decompensated Heart Failure National Registry)-also highlights differences between patients hospitalized for heart failure in the United States and those selected for clinical trials in acute heart failure.

According to the analysis, 83% of discharged patients had measures of left ventricular function performed or scheduled, an essential measure of heart failure. Only 66% received JCAHO-recommended ACE inhibitors at discharge, and only 40% received recommended smoking-cessation counseling.

"These findings present a real-world perspective of heart-failure patients in the U.S. today and offer information about these patients that cannot be obtained from traditional randomized clinical trials," said lead study investigator, Kirkwood F. Adams Jr., MD, associate professor of medicine and radiology and director of the University of North Carolina Heart Failure Program.

Heart failure usually occurs when the heart muscle becomes weakened or damaged and lacks the strength to pump enough blood to meet the body's needs. According to the American Heart Association, heart failure is a serious condition that affects nearly 5 million Americans, with 550,000 new cases each year. It is the most frequent cause of hospitalization in patients over 65 years of age.

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