Situación actual del abordaje integral de la insuficiencia cardiaca en España. Proyecto OPTIMISE-IC

Abstract

Introduction and objectivesTo determine the current situation about the clinical management of heart failure (HF) in primary care (PC) and cardiology, in order to identify potential areas for improvement in the healthcare continuity. MethodsThe program was implemented through joint work sessions between PC and cardiology in our country, in which possible deficiencies, difficulties, and areas for improvement were identified in the integrative management of patients with HF. Results66 sessions were performed throughout Spain, with a total of 1187 attendees. 61.8% of the participants indicated that the healthcare centers did not have a HF cardiology referrer, in 64.7% the relationship between both healthcare levels was isolated and communication was carried out predominantly through telematic tools. 88.2% of PC physicians could request natriuretic peptides directly, but in 75.8% the echocardiogram had to be requested through cardiology. In 61.8% of the cases there was a therapeutic plan to optimize the treatment with quadruple therapy, although in 82.4% the full doses were not attained. In most centers (60.3%) there was no expert nurse in the management of HF. ConclusionsIn Spain there are significant deficiencies in the integrative management of patients with HF. A higher education of PC physicians and nurses, a better coordination between both healthcare levels, and the development of local protocols that facilitates treatment optimization, could be helpful to improve this situation.