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01-09-2010 | Onderzoek
Behandeling van chronisch hartfalen
Auteurs: dr. M. Bosch, dr. M. Wensing, prof.dr. R. T. P. M. Grol, : dr. J. C. Bakx, : prof.dr. T. van der Weijden, prof.dr. A. W. Hoes
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Samenvatting
Bosch M, Wensing M, Bakx JC, Van der Weijden T, Hoes AW, Grol RPTM. Behandeling van chronisch hartfalen. Huisarts Wet 2010;53(12):667-70.
Achtergrond
Vóór 2005, het jaar waarin de eerste herziening van de NHG-Standaard Hartfalen verscheen, kregen patiënten met chronisch hartfalen niet altijd de best mogelijke behandeling. Wij hebben onderzocht hoe de stand van zaken was na de verschijning van de herziene standaard.
Methode
In 2005-2006 onderzochten wij de medische dossiers van 357 patiënten uit 42 Nederlandse huisartsenpraktijken. Deze gegevens vulden wij aan met behulp van vragenlijsten aan patiënten en huisartsen.
Resultaten
De gemiddelde leeftijd van de patiënten was 75,7 jaar (SD 10,2), 53% was man en 73% had mild hartfalen. Onder de voorgeschreven middelen waren diuretica (76,5% van de patiënten), bètablokkers (54,6%), ACE-remmers (40,6%), spironolacton (24,9%) en angiotensine-II-receptorblokkers (20,7%). De kans dat de patiënt volgens de aanbevelingen werd behandeld, nam af naarmate het hartfalen ernstiger was. Op de niet-medicamenteuze behandeling scoorden de huisartsen slechter dan op de medicamenteuze: de leefstijladviezen die de NHG-Standaard aanbeveelt, bereikten ongeveer de helft van de patiënten.
Conclusie
De herziene NHG-Standaard Hartfalen heeft de behandeling van hartfalenpatiënten weliswaar naar een hoger niveau getild, maar het kan nog altijd beter, vooral als het gaat om monitoring en leefstijladviezen.
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Metagegevens
- Titel
- Behandeling van chronisch hartfalen
- Auteurs
-
dr. M. Bosch
dr. M. Wensing
prof.dr. R. T. P. M. Grol
: dr. J. C. Bakx
: prof.dr. T. van der Weijden
prof.dr. A. W. Hoes
- Publicatiedatum
- 01-09-2010
- Uitgeverij
- Bohn Stafleu van Loghum
- DOI
- https://doi.org/10.1007/s12445-010-0305-z