Imperial College London
Alternate

PROFESSOR AZEEM MAJEED

Faculty of Medicine, School of Public Health

Chair - Primary Care and Public Health & Head of Department
 
 
 
//

Contact

 

+44 (0)20 7594 3368a.majeed Website

 
 
//

Assistant

 

Ms Dorothea Cockerell +44 (0)20 7594 3368

 
//

Location

 

Reynolds BuildingCharing Cross Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Bottle:2018:10.1136/heartjnl-2017-312183,
author = {Bottle, A and Kim, D and Aylin, P and Cowie, MR and Majeed, A and Hayhoe, B},
doi = {10.1136/heartjnl-2017-312183},
journal = {Heart},
pages = {600--605},
title = {Routes to diagnosis of heart failure: observational study using linked data in England},
url = {http://dx.doi.org/10.1136/heartjnl-2017-312183},
volume = {104},
year = {2018}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: Timely diagnosis and management of heart failure (HF) is critical, but identification of patients with suspected HF can be challenging, especially in primary care. We describe the journey of people with HF in primary care from presentation through to diagnosis and initial management. METHODS: We used the Clinical Practice Research Datalink (primary care consultations linked to hospital admissions data and national death registrations for patients registered with participating primary care practices in England) to describe investigation and referral pathways followed by patients from first presentation with relevant symptoms to HF diagnosis, particularly alignment with recommendations of the National Institute for Health and Care Excellence guideline for HF diagnosis. RESULTS: 36 748 patients had a diagnosis of HF recorded that met the inclusion criteria between 1 January 2010 and 31 March 2013. For 29 113 (79.2%) patients, this was first recorded in hospital. In the 5 years prior to diagnosis, 15 057 patients (41.0%) had a primary care consultation with one of three key HF symptoms recorded, 17 724 (48.2%) attended for another reason and 3967 (10.8%) did not see their general practitioner. Only 24% of those with recorded HF symptoms followed a pathway aligned with guidelines (echocardiogram and/or serum natriuretic peptide test and specialist referral), while 44% had no echocardiogram, natriuretic peptide test or referral. CONCLUSIONS: Patients follow various pathways to the diagnosis of HF. However, few appear to follow a pathway supported by guidelines for investigation and referral. There are likely to be missed opportunities for earlier HF diagnosis in primary care.
AU  - Bottle,A
AU  - Kim,D
AU  - Aylin,P
AU  - Cowie,MR
AU  - Majeed,A
AU  - Hayhoe,B
DO  - 10.1136/heartjnl-2017-312183
EP  - 605
PY  - 2018///
SN  - 1355-6037
SP  - 600
TI  - Routes to diagnosis of heart failure: observational study using linked data in England
T2  - Heart
UR  - http://dx.doi.org/10.1136/heartjnl-2017-312183
UR  - https://heart.bmj.com/content/104/7/600
UR  - http://hdl.handle.net/10044/1/51806
VL  - 104
ER  -
Download