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@article{McCambridge:2020:10.1002/ehf2.13089,
author = {McCambridge, J and Keane, C and Walshe, M and Campbell, P and Heyes, J and Kalra, PR and Cowie, MR and Riley, JP and O'Hanlon, R and Ledwidge, M and Gallagher, J and McDonald, K},
doi = {10.1002/ehf2.13089},
journal = {ESC Heart Failure},
pages = {1076--1084},
title = {The prehospital patient pathway and experience of care with acute heart failure: a comparison of two health care systems},
url = {http://dx.doi.org/10.1002/ehf2.13089},
volume = {8},
year = {2020}
}

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TY  - JOUR
AB  - AimsThis study aimed to analyse community management of patients during the symptomatic period prior to admission with acute decompensated heart failure (ADHF).Methods and resultsWe conducted a prospective, two-centre, two-country observational study evaluating care pathways and patient experience in patients admitted to hospital with ADHF. Quantitative and qualitative data were gathered from patients, carers, and general practitioners (GPs). From the Irish centre, 114 patients enrolled, and from the English centre, 50 patients. Symptom duration longer than 72 h prior to hospitalization was noted among 70.4% (76) Irish and 80% (40) English patients, with no significant difference between those with a new diagnosis of HF [de novo HF (dnHF)] and those with known HF [established HF (eHF)] in either cohort. For the majority, dyspnoea was the dominant symptom; however, 63.3% (31) of these Irish patients and 47.2% (17) of these English patients did not recognize this as an HF symptom, with no significant difference between dnHF and eHF patients. Of the 46.5% (53) of Irish and 38% (19) of English patients reviewed exclusively by GPs before hospitalization, numbers prescribed diuretics were low (11.3%, six; and 15.8%, three, respectively); eHF patients were no more likely to receive diuretics than dnHF patients. Barriers to care highlighted by GPs included inadequate access to basic diagnostics, specialist support and up-to-date patient information, and lack of GP comfort in managing HF.ConclusionThe aforementioned findings, consistent across both health care jurisdictions, show a clear potential to intervene earlier and more effectively in ADHF or to prevent the need for hospitalization.
AU  - McCambridge,J
AU  - Keane,C
AU  - Walshe,M
AU  - Campbell,P
AU  - Heyes,J
AU  - Kalra,PR
AU  - Cowie,MR
AU  - Riley,JP
AU  - O'Hanlon,R
AU  - Ledwidge,M
AU  - Gallagher,J
AU  - McDonald,K
DO  - 10.1002/ehf2.13089
EP  - 1084
PY  - 2020///
SN  - 2055-5822
SP  - 1076
TI  - The prehospital patient pathway and experience of care with acute heart failure: a comparison of two health care systems
T2  - ESC Heart Failure
UR  - http://dx.doi.org/10.1002/ehf2.13089
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000601327300001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://onlinelibrary.wiley.com/doi/10.1002/ehf2.13089
UR  - http://hdl.handle.net/10044/1/93314
VL  - 8
ER  -

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