Physician and patient predictors of evidence-based prescribing in heart failure: a multilevel study.

PloS One
Frank Peters-KlimmChristoph Nikendei

Abstract

The management of patients with heart failure (HF) needs to account for changeable and complex individual clinical characteristics. The use of renin angiotensin system inhibitors (RAAS-I) to target doses is recommended by guidelines. But physicians seemingly do not sufficiently follow this recommendation, while little is known about the physician and patient predictors of adherence. To examine the coherence of primary care (PC) physicians' knowledge and self-perceived competencies regarding RAAS-I with their respective prescribing behavior being related to patient-associated barriers. Cross-sectional follow-up study after a randomized medical educational intervention trial with a seven month observation period. PC physicians (n = 37) and patients with systolic HF (n = 168) from practices in Baden-Wuerttemberg. Measurements were knowledge (blueprint-based multiple choice test), self-perceived competencies (questionnaire on global confidence in the therapy and on frequency of use of RAAS-I), and patient variables (age, gender, NYHA functional status, blood pressure, potassium level, renal function). Prescribing was collected from the trials' documentation. The target variable consisted of ≥50% of recommended RAAS-I dosage being i...Continue Reading

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Citations

Jan 18, 2019·Journal of Clinical Nursing·Rocío Fernández-MéndezGary George Adams
May 16, 2018·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Inder Anand
Feb 23, 2019·European Journal of Medical Research·Valentin TerhoevenSven T Pleger

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Methods Mentioned

BETA
pharmacotherapy

Clinical Trials Mentioned

ISRCTN08601529

Software Mentioned

SAS
SPSS

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