Management of heart failure in private practice: Current situation

Abstract

Introduction

The optimization of care for heart failure (HF) patients often remains imperfect, particularly in terms of increasing pharmacological treatments and monitoring warning signs at home. To enhance practices in this field, we conducted a survey to better understand the habits of private cardiologists and the current obstacles to managing HF patients.

Objective

To better understand the habits of private cardiologists and the current obstacles to manage HF patients.

Method

A working group of private cardiologists who are members of the GICC established a questionnaire distributed to all private cardiologists between January and March 2024 via a QR code during JESFC events, as well as email dissemination and social media through the cardiologists’ union and the SFC. Responses were collected anonymously.

Results

252 cardiologists completed the questionnaire, although 52 were not usable. The average age was 54 years, with a majority practicing in group practices (107) and 34% combining practice in both outpatient clinics and hospitals. Responding cardiologists reported seeing an average of 15 HF patients per week. 98% of them believe that private cardiologists play an important role in HF management, especially for compensated chronic HF. Obstacles to this management included lack of training, complexity of care, and lack of time. Regarding available tools for HF management, 41% utilized tele-expertise and 48% telemonitoring. Reasons for not utilizing tele-expertise included perceived complexity (30%), unfamiliarity with the tool (25%), work habits (preference for phone calls for 20% of practitioners), or perceived uselessness (18%). Reasons for not using telemonitoring included complexity (45%), unfamiliarity with the tools (22%), low reimbursement (12%), or perceived uselessness (10%). Private cardiologists expressed a need for specific training in HF management in the form of Continuing Professional Development (57%) or practical guidelines (49%), facilitated by the GICC (68%).

Conclusion

This sample of private cardiologists believes they have a key role in managing chronic HF. However, they face the complexity of this task and express a need for specific training. Greater awareness of new telemedicine tools could contribute to improving patient management.