Heart failure drugs underprescribed, audit finds

Many heart failure patients are receiving inadequate drug doses from NHS hospitals, a health audit has shown.

The National Heart Failure Audit, which covered 21,000 patient records, suggested many patients are prescribed less than 50% of the target dose of ACE inhibitors and beta blockers.

The report showed the death rate was ‘unacceptably high’ among hospitalised patients with HF.

Although 32% of HF patients died within a year of hospital admission, this fell to 23% among patients who were seen by a cardiologist or had access to specialist HF services.

HF patients on non-cardiac wards were twice as likely to die compared to those on specialist wards.

Prescription of drugs for HF was also lacking. Of the 17,520 patients with recorded data about the use of beta blockers, 60% were prescribed them.

The level of dosage was often not recorded and for the 5,210 patients with a dosage record, two thirds received less than 50% of the target dose.

Furthermore, half of the 5,930 patients with a record of ACE Inhibitors received less than 50% of the target dose.

Dr Theresa McDonagh, chair of the British Society for Heart Failure and audit clinical lead said: ‘This audit shows that patients admitted to hospital with heart failure have an unacceptably high death rate.

‘Outcomes for these patients can be significantly improved by having specialist cardiology input to their care, administration of appropriate evidence-based doses of key drugs and follow-up by specialist services.’

Dr Mike Knapton, associate medical director at the British Heart Foundation, said: 'Treatment for heart failure should be given the same priority as heart attacks. But while there have been huge improvements in the management of heart attack patients, the same cannot be said for people with heart failure, where improvements have been too slow.

'People are still needlessly dying because they do not have access to specialist cardiological care.'

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