FREQUENCY OF COMPLIANCE TO GUIDELINE RECOMMENDED TREATMENT IN HEART FAILURE PATIENTS WITH LVEF <40%
Objective: To determine the frequency of compliance to guideline recommended treatment among patients with STAGE-C or STAGE-D heart failure and LVEF<40%.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Adult cardiology department of AFIC/NIHD, Rawalpindi, from Sept to Dec 2019.
Methodology: Eighty Four patients of Heart Failure with reduced LVEF after satisfying inclusion and exclusion criteria were recruited in this study through non-probability consecutive sampling technique. Data was collected from ER and OPD patients through complete history based on demographics (i.e. age and gender), co-morbidities (i.e. diabetes, hypertension, CAD and smoking history), previous EF record measured on 2D-echo, functional improvement of the patients using NYHA dyspnea class and guideline recommended medication history with compliance. The data was analyzed using SPSS version 23.
Results: A total of 84 patients of Heart Failure with LVEF = 31.61 ± 7.61% were enrolled out of whom 62 (73.8%) were male and 22 (26.2%) female patients. The mean age of patients was 62.26 ± 9.879 years. About 30 (35.7%) patients were diabetic, 44 (52.4%) were hypertensive, 19 (22.6%) were current smokers, 16 (19%) were ex-smokers and 49 (58.2%) were nonsmokers. Those with history of CAD were (SVCAD=8 (9.5%), DVCAD=14 (16.7%),
TVCAD 15 (17.9%). Compliance of patients to treatment was 74 (88.1%) good. Patients presenting with NYHA Class I/II 3 (3.6%)/20 (23.6%) showed significant improvement after medical therapy 34 (40.5%)/30 (35.7%), whereas those with class III/IV did not show significant improvement in functional status.
Conclusion: This survey shows that patient’s compliance is relatively goods but patients with NYHA III/IV were receiving suboptimal treatment. Secondly patients presenting with NYHAI/II after medical therapy showed significant improvement in functional status as compared to those with NYHA III/IV. Thereby further actions are needed for improving quality of life and standard of care among HF patients by optimization of treatment
according to guidelines.