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Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial
AIMS: To assess whether a single training session for general practitioners (GPs) improves the evidence-based drug treatment of heart failure (HF) patients, especially of those with HF with reduced ejection fraction (HFrEF). METHODS AND RESULTS: A cluster randomised controlled trial was performed fo...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bohn Stafleu van Loghum
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7596131/ https://www.ncbi.nlm.nih.gov/pubmed/32997300 http://dx.doi.org/10.1007/s12471-020-01487-x |
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author | Valk, M. J. M. Hoes, A. W. Mosterd, A. Landman, M. A. Zuithoff, N. P. A. Broekhuizen, B. D. L. Rutten, F. H. |
author_facet | Valk, M. J. M. Hoes, A. W. Mosterd, A. Landman, M. A. Zuithoff, N. P. A. Broekhuizen, B. D. L. Rutten, F. H. |
author_sort | Valk, M. J. M. |
collection | PubMed |
description | AIMS: To assess whether a single training session for general practitioners (GPs) improves the evidence-based drug treatment of heart failure (HF) patients, especially of those with HF with reduced ejection fraction (HFrEF). METHODS AND RESULTS: A cluster randomised controlled trial was performed for which patients with established HF were eligible. Primary care practices (PCPs) were randomised to care-as-usual or to the intervention group in which GPs received a half-day training session on HF management. Changes in HF medication, health status, hospitalisation and survival were compared between the two groups. Fifteen PCPs with 200 HF patients were randomised to the intervention group and 15 PCPs with 198 HF patients to the control group. Mean age was 76.9 (SD 10.8) years; 52.5% were female. On average, the patients had been diagnosed with HF 3.0 (SD 3.0) years previously. In total, 204 had HFrEF and 194 HF with preserved ejection fraction (HFpEF). In participants with HFrEF, the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers decreased in 6 months in both groups [5.2%; (95% confidence interval (CI) 2.0–10.0)] and 5.6% (95% CI 2.8–13.4)], respectively [baseline-corrected odds ratio (OR) 1.07 (95% CI 0.55–2.08)], while beta-blocker use increased in both groups by 5.2% (95% CI 2.0–10.0) and 1.1% (95% CI 0.2–6.3), respectively [baseline-corrected OR 0.82 (95% CI 0.42–1.61)]. For health status, hospitalisations or survival after 12–28 months there were no significant differences between the two groups, also not when separately analysed for HFrEF and HFpEF. CONCLUSION: A half-day training session for GPs does not improve drug treatment of HF in patients with established HF. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12471-020-01487-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7596131 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-75961312020-11-10 Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial Valk, M. J. M. Hoes, A. W. Mosterd, A. Landman, M. A. Zuithoff, N. P. A. Broekhuizen, B. D. L. Rutten, F. H. Neth Heart J Original Article AIMS: To assess whether a single training session for general practitioners (GPs) improves the evidence-based drug treatment of heart failure (HF) patients, especially of those with HF with reduced ejection fraction (HFrEF). METHODS AND RESULTS: A cluster randomised controlled trial was performed for which patients with established HF were eligible. Primary care practices (PCPs) were randomised to care-as-usual or to the intervention group in which GPs received a half-day training session on HF management. Changes in HF medication, health status, hospitalisation and survival were compared between the two groups. Fifteen PCPs with 200 HF patients were randomised to the intervention group and 15 PCPs with 198 HF patients to the control group. Mean age was 76.9 (SD 10.8) years; 52.5% were female. On average, the patients had been diagnosed with HF 3.0 (SD 3.0) years previously. In total, 204 had HFrEF and 194 HF with preserved ejection fraction (HFpEF). In participants with HFrEF, the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers decreased in 6 months in both groups [5.2%; (95% confidence interval (CI) 2.0–10.0)] and 5.6% (95% CI 2.8–13.4)], respectively [baseline-corrected odds ratio (OR) 1.07 (95% CI 0.55–2.08)], while beta-blocker use increased in both groups by 5.2% (95% CI 2.0–10.0) and 1.1% (95% CI 0.2–6.3), respectively [baseline-corrected OR 0.82 (95% CI 0.42–1.61)]. For health status, hospitalisations or survival after 12–28 months there were no significant differences between the two groups, also not when separately analysed for HFrEF and HFpEF. CONCLUSION: A half-day training session for GPs does not improve drug treatment of HF in patients with established HF. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12471-020-01487-x) contains supplementary material, which is available to authorized users. Bohn Stafleu van Loghum 2020-09-30 2020-11 /pmc/articles/PMC7596131/ /pubmed/32997300 http://dx.doi.org/10.1007/s12471-020-01487-x Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Valk, M. J. M. Hoes, A. W. Mosterd, A. Landman, M. A. Zuithoff, N. P. A. Broekhuizen, B. D. L. Rutten, F. H. Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial |
title | Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial |
title_full | Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial |
title_fullStr | Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial |
title_full_unstemmed | Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial |
title_short | Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial |
title_sort | training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7596131/ https://www.ncbi.nlm.nih.gov/pubmed/32997300 http://dx.doi.org/10.1007/s12471-020-01487-x |
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