Application of the Canadian Cardiovascular Society's heart failure guidelines in a heart function clinic

Abstract

Keywords: Heart Failure, Guideline Adherence, Evidence Based-Practice

Purpose: Heart failure is a significant diagnosis that poses serious mortality and morbidity risks. Many studies have assessed the efficacy of evidence-based guidelines in improving patient outcomes in the management of heart failure; however, there is limited data on how these guidelines are applied in clinical practice.

Methods: A retrospective, cross-sectional approach was used to examine a physician‘s adherence to the Canadian Cardiovascular Society‘s (CCS) most recent practice guidelines on managing heart failure. Data was collected from electronic hospital health records and patient charts of patients enrolled in a heart function clinic. Qualitative and quantitative analyses were done to compare current clinical practices related to investigations, treatment, and follow-up to the guidelines.

Results: A total of 37 patients met inclusion criteria for this study (n=37). The majority of patients were males, 81%, with an average age of 71 years, 10 medications with 5.5 comorbidities. Recommendations regarding wait times, frequency of follow-up, and blood work were met 97%, 78%, and 64% of participants, respectively with most patients being reassessed more frequently than the guideline recommendation. Medical therapy recommendations were met in over 70% of participants. All participants had EF assessments as frequently or more frequently than guideline requirements.

Conclusion: Overall, the Heart Function Clinic practices assessed in this study align well with the current guidelines recommended by the CCS. Although this study is by no means comprehensive, it provides an initial glimpse into how practice guidelines may be applied in clinical practice and identifies areas where further work needs to be done.