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首页> 外文期刊>Journal of Clinical Medicine Research >The Impact of a Heart Failure Educational?Program for Physicians?Varies Based Upon Physician Specialty
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The Impact of a Heart Failure Educational?Program for Physicians?Varies Based Upon Physician Specialty

机译：心力衰竭医师教育计划的影响因医师的专业而异

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Background: Beta blocker (BB) doses are often suboptimal in heart failure (HF) management. Differences in BB management patterns may exist between physicians in family medicine (FM) and internal medicine (IM). The aims of this study were to compare: 1) BB doses and prescription patterns; and 2) health care utilization rates in patients cared for by all primary care physicians compared to an historical control group after an educational program on HF management. A subgroup analysis was performed between patients cared for by FM and IM physicians. A secondary aim was to assess physician knowledge scores and satisfaction. Methods: A historically controlled study was conducted among low-income, underserved HF patients (mean age 54.1 ± 13.1, males 70%, mean ejection fraction 28.2 ± 9.8%). Statistical methods included linear mixed models and Fisher’s exact tests to assess prescription patterns of BB dosing and health care utilization rates (all cause and HF related hospitalizations, emergency department use and clinic visits). Results: Among 135 patients (experimental N = 81 and control N = 54), a linear mixed model test of group by time interaction showed no difference in BB dosage (t = -0.12, P = 0.91). FM physicians prescribed significant changes in BB doses compared to IM physicians (P = 0.04), had higher numbers of clinic visits (P = 0.03) and reported greater satisfaction with the program. Conclusions: There was no difference in BB titration rates following an HF training intervention for physicians compared to historical controls. However, FM physicians had a greater change in prescribing practices compared to IM physicians. Educational programs targeting FM physicians may benefit HF patients and could potentially lead to greater adherence to clinical guidelines related to BB use and address gaps in providing HF care.J Clin Med Res. 2014;6(3):173-183 doi: http://dx.doi.org/10.14740/jocmr1790w
机译：背景：在心力衰竭（HF）管理中，β受体阻滞剂（BB）剂量通常次优。家庭医学（FM）和内科医学（IM）的医生之间可能存在BB管理模式的差异。本研究的目的是比较：1）BB剂量和处方模式; 2）经过HF管理教育计划后，与历史对照组相比，所有初级保健医生所护理患者的卫生保健利用率。在FM和IM医师照顾的患者之间进行了亚组分析。第二个目的是评估医师的知识得分和满意度。方法：对低收入，服务欠佳的HF患者（平均年龄54.1±13.1，男性70％，平均射血分数28.2±9.8％）进行历史对照研究。统计方法包括线性混合模型和Fisher精确检验，以评估BB剂量的处方模式和医疗保健利用率（所有原因和HF相关的住院，急诊室使用和诊所就诊）。结果：在135例患者（实验N = 81，对照组N = 54）中，按时间相互作用进行的线性混合模型测试显示BB剂量无差异（t = -0.12，P = 0.91）。与IM医师相比，FM医师规定BB剂量有显着变化（P = 0.04），诊所就诊次数较多（P = 0.03），并且报告对该计划的满意度更高。结论：与历史对照相比，对医生进行HF培训后的BB滴定率没有差异。但是，与IM医师相比，FM医师的处方实践发生了较大变化。针对FM医师的教育计划可能会使HF患者受益，并可能导致对与BB使用相关的临床指南的更多遵守，并解决提供HF护理方面的空白。 2014; 6（3）：173-183 doi：http://dx.doi.org/10.14740/jocmr1790w

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