|
|
|
|
||
|
||
|
|
||
| SEARCH | SUBSCRIBE | ||
|
 |
Do doctors sometimes fail their heart
failure patients? New study seeks hard data
By Joe Muehlenkamp
Eurekalert, August 21, 2003
ST.
LOUIS - What's the best way to manage a patient who's dying of heart
failure? And just how do physicians make decisions about this ever-growing
population of patients, particularly those in the end stages of the
disease? These are two questions that a cardiologist
at Saint Louis University is seeking to answer as part of research
sponsored by the National Institutes of Aging. The project, funded by a
$721,000 grant from the NIA, begins this summer and will continue for four
years. "Congestive heart failure is a disease
of increasing prevalence, accounting for high morbidity and
mortality," said lead researcher Paul J. Hauptman, M.D., a
cardiologist at Saint Louis University School of Medicine. "This is a
disease of the elderly, so as baby boomers age we need to start
understanding more about how physicians in multiple specialty areas
actually treat these patients. Ultimately, we want to figure out how to
best take care of patients with end-stage heart failure." The risk of heart failure, which affects 2 to
3 million Americans, is more common among elderly patients and increases
with age. About 5 percent of those who are 75 have the condition, compared
to 1 percent of those age 50. Dr. Hauptman's study has two major parts: ·
The study evaluates a
medical therapy, the infusion of inotropic drugs, which is associated with
high costs, unproven clinical efficacy and the potential to shorten
survival while achieving palliation. "This therapy makes patients
feel better, but it's unclear whether it helps them live longer,"
Hauptman said. Researchers will use administrative and
clinical data from several Medicare databases for the period 1997 to 2001.
The population of older Medicare beneficiaries receiving and the
physicians prescribing this therapy will be described and contrasted with
the demographics and outcomes of older patients hospitalized for heart
failure but not receiving the drugs. The data will be used so doctors can better
predict how inotrope use affects mortality and other factors in this
high-risk group. ·
The second part
involves a survey of 1,200 cardiologists, geriatricians, internists and
family/general practitioners from across the country to assess how their
knowledge and attitudes influence their practices in treating end-stage
heart failure patients. Approximately one-third of the physicians will be
known prescribers of inotropic drugs. "We plan to investigate how physicians
make decisions and the degree to which the care of the end-stage patient
is influenced by physician specialty, volume or other factors,"
Hauptman said. "When complete, these studies will form
a framework for physicians to use when selecting care options, including
palliation, for older heart failure patients near the end of life,"
he said. ### Copyright
© 2002 Global Action on Aging
|
