| dc.description.abstract | Investigation and treatment of heart failure in primary health care – a comparative study of medical records with regard to gender and age
Filippa Buller
Primary Health Care Unit, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Sweden.
Introduction: Heart failure is a public health disease. In Sweden today there are approximately 250,000 people with heart failure, which corresponds to 2–3% of the entire population. The prognosis is, in many cases, worse than for some common cancerous diseases. The recommended medical treatment for heart failure, B-inhibitors and RAS-inhibitors reduces mortality and morbidity for heart failure with reduced ejection fraction. According to National Board of Health and Wellfare 59% of the heart failure-patients in Sweden received recommended medical treatment in 2014. Women received recommended treatment less often than men.
Aim: To investigate whether there is any gender or age difference in how patients with heart failure are investigated and treated at Kungshöjds Health Center.
Method: A study of medical records at Kungshöjds Health Center in central Gothenburg, including 98 heart failure patients, 49 females and 49 men. Two subgroups were created to investigate how heart failure patients were investigated and treated, population 1 (n=48) with those diagnosed at the health center and population 2 (n=74) with those who were treated at the health center. The journals were examined with regard to medical history, clinical findings, the investigations that were made and received treatment. Statistical analyses were made with SPSS.
Results: Women with heart failure were significant older than men with heart failure. Echocardiography was performed less often in older patients, n=5 (19,2%), than in younger patients n=11 (50%; p 0,024). Symptoms like dyspnea and leg edema were documented less often in older patients n=16 (61,5%) and n=14 (53,8%) compared to younger n=19 (84,6%) and n=19 (84,6%), (p=0.054) and (p=0.015). Older patients n=13 (34,2%) compared to younger
patients n=28 (77,8%) were less likely to receive recommended heart failure treatment (p <0,001). There was no significant gender difference in investigations and treatment of heart failure.
Conclusions: This journal study of patients with heart failure at the Kungshöjd Health Center showed that men and women were treated and investigated equally, but there was a difference between age groups for both investigation and treatment. Older patients were less likely to undergo UCG and receive the recommended treatment. This implies that UCG needs to be performed more often, as well as being more easily accessible. | sv |
