[Awareness and Expectations of Primary Care Clinicians in Chronic Heart Failure Management].

Zeki Gündüz, Furkan Gençer, Ahmet Berk Duman, Abdulcebbar Şipal, Müjdat Aktaş, Onur Argan, Serdar Bozyel
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Abstract

Objective: Chronic heart failure (CHF) management requires a multidisciplinary approach, and it's very important for primary care physicians (PCC) to cooperate with cardiology physicians in this process. In this study, we tried to reveal the awareness and expectations of PCC about CHF management.

Methods: The study was designed as a descriptive survey in a single region and included 549 PCC. Data were collected through a survey study.

Results: A total of 389 PCC participated in our study. Of these, 137 (35.2%) stated that they had an average of more than 40 CHF patients registered with them, and 331 (85.1%) stated that they had identified them thanks to their medical treatment. The symptoms that physicians most frequently question in CHF patients are shortness of breath (27.5%), swelling in the ankle (27%), orthopnea (23.9%) and palpitations (20.5%). The physical examination findings that they question most frequently are peripheral edema (% 29.2), tachycardia (18.5%), crepitus in the lungs (16.8%), and irregular pulse (15.2%). 203 (55.9%) of PCC stated that measurements of natriuretic peptides could be implemented in their institutions if the necessary training and opportunity were provided. Most physicians (46.8%) stated that they should be given priority in referring CHF patients; 172 of them (44.2%) stated that they received in-service training regarding CHF and 278 of them (71.5%) stated that their training was not at a sufficient level.

Conclusion: It is clear that better results can be obtained in the management of CHF as the education level and professional experience of PHCs increases. It seems that PCC need training on CHF and need to improve the quality of communication with cardiologist's.

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[初级保健临床医生对慢性心力衰竭管理的认识和期望]。
目的:慢性心力衰竭(CHF)管理需要多学科方法,在此过程中,初级保健医生(PCC)与心脏病医生的合作非常重要。在这项研究中,我们试图揭示初级保健医生对慢性心力衰竭管理的认识和期望:研究设计为描述性调查,在一个地区进行,包括 549 名初级保健医生。通过调查研究收集数据:结果:共有 389 名 PCC 参与了我们的研究。其中,137 人(35.2%)表示他们平均登记了 40 多名慢性阻塞性肺病患者,331 人(85.1%)表示他们是通过医疗手段发现这些患者的。医生最常询问慢性阻塞性肺病患者的症状是呼吸急促(27.5%)、踝关节肿胀(27%)、呼吸困难(23.9%)和心悸(20.5%)。他们最常询问的体格检查结果是外周水肿(29.2%)、心动过速(18.5%)、肺部吱吱作响(16.8%)和脉搏不规则(15.2%)。有 203 名 PCC(55.9%)表示,如果能提供必要的培训和机会,他们所在的医疗机构可以进行利钠肽的测量。大多数医生(46.8%)表示,在转诊慢性阻塞性肺病患者时应优先考虑他们;其中 172 名医生(44.2%)表示他们接受过有关慢性阻塞性肺病的在职培训,278 名医生(71.5%)表示他们的培训水平不够:结论:很明显,随着初级保健医生教育水平和专业经验的提高,在管理慢性心力衰竭方面可以取得更好的效果。看来,初级保健协调员需要接受有关慢性阻塞性肺病的培训,并需要提高与心脏病专家沟通的质量。
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