Making Best Practice, Every Day Practice
A number of drug classes are used in the treatment of patients with heart failure. This illustrated Back to Basics infographic describes the various drugs and their mechanisms of action to give health care professionals and their patients a greater understanding of heart failure management.
This audit was carried out using the GRASP-HF audit tool developed by PRIMIS designed to help busy practices achieve a systematic approach to the identification, diagnosis and management of patients with HF.
Nobody likes to talk about failure. We hide from it, shy away from it. Society demands positivity. And so, we do not necessarily take the time or put the effort into learning from failure. Heart Failure is a misunderstood and misdiagnosed condition, as malignant as some of the most common cancers, it should be treated with […]
Working with patients who are not willing to engage fully with healthcare services is a common occurrence. The process requires patience and a focus on providing the patient with full information about their condition and then allowing them to make decisions about their treatment. Here, Dr Terry McCormack (GP and Cardiovascular Lead, North Yorks) describes the approach of his practice to a man with hypertension.
Although overall CV mortality has declined in recent years, patients with clinically manifest CVD remain at increased risk of recurrent CV events. A group of HCPs at UK primary and secondary care centres have recently developed a consensus statement to improve delivery of secondary prevention in the UK.
The updated Chronic Heart Failure guideline from the National Institute for Health and Care Excellence was published in September. This article covers the key recommendations relevant to primary care.
Heart failure (HF) is a devastating clinical syndrome characterised by a constellation of symptoms and signs in the presence of reduced cardiac function. Comorbidity is almost inherent as HF is often the culmination of chronic disease processes such as ischaemic heart disease, hypertension and valve disease and its treatment may precipitate comorbidities such as gout, erectile dysfunction (ED) and acute kidney injury (AKI).
Ischaemic or coronary heart disease is the single leading cause of death in any Western population but more critically is one of the leading causes of premature deaths (i.e. deaths 75 years) in both men and women. There are numerous risk factors for ischaemic heart disease and understanding these and other comorbidities is critical to achieving optimal outcomes.
The large randomised controlled trial PARADIGM-HF showed that treatment with sacubitril/valsartan (Entresto) compared with enalapril reduced the risk of hospitalisation, cardiovascular and all-cause mortality and improved symptoms in patients with heart failure with reduced ejection fraction. This article describes the key results and how they can be applied in primary care.
HF has a major impact on patients, their families, the NHS and social care services. It still has a poor prognosis, worse than many of the common cancers that also affect older people. It causes significant morbidity and imposes a major cost burden on the health service. This editorial provides an introduction to a special supplement on a first-in-class oral treatment for heart failure.
Commissioning is not so different from seeing patients. As a GP you listen, examine, draw up a diagnosis and plan treatment. In commissioning, the community served by the clinical commissioning group (CCG) is the ‘patient’. When considering the introduction of a new treatment for heart failure (HF) such as sacubitril/valsartan (Entresto), we must consider not only its acquisition costs but also its potential benefits in improving patients’ symptoms and reducing expensive hospital admissions.
Sacubitril/valsartan (Entresto), the first angiotensin receptor-neprilysin inhibitor (ARNI), is a recently licensed medication that has been shown to improve outcomes for patients with symptomatic chronic HF with reduced ejection fraction (HF-REF) compared with current gold-standard treatment with an ACE inhibitor. This article describes the pharmacist’s role in supporting patients receiving sacubitril/valsartan.
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