Failure of Guidelines and Consensus Statements to Recommend Follow-up for Chronic Cardiovascular Conditions.

Autor: Patel K; Department of Internal Medicine, University of New Mexico, Albuquerque, NM., Maestas CM; University of Virginia Health Science Center, Charlottesville, VA., Petrechko O; Department of Internal Medicine, University of New Mexico, Albuquerque, NM., Boja H; Presbyterian Health System, Albuquerque, NM., Blankenship JC; Division of Cardiology, University of New Mexico, Albuquerque, NM. Electronic address: jblankenship@salud.unm.edu.
Jazyk: angličtina
Zdroj: Heart & lung : the journal of critical care [Heart Lung] 2023 May-Jun; Vol. 59, pp. 128-138. Date of Electronic Publication: 2023 Feb 16.
DOI: 10.1016/j.hrtlng.2023.01.002
Abstrakt: Background: Many cardiac conditions require long-term clinical follow-up to monitor progression of disease and tolerance and adherence to therapies. Providers are often unsure as to the frequency of clinical follow-up and who should provide the follow-up. In the absence of formal guidance, patients may be seen more frequently than necessary - thereby limiting clinic space for other patients, or not frequently enough, potentially leading to undetected progression of disease.
Objectives: To determine the extent to which guidelines (GL)/consensus statements (CS) provide guidance about appropriate follow-up for common cardiovascular conditions.
Methods: We identified 31 chronic cardiovascular disease conditions for which long-term (beyond 1 year) follow-up is indicated and used PubMed and professional society websites to identify all relevant GL/CS (n = 33) regarding these chronic cardiac conditions.
Results: Of the 31 cardiac conditions reviewed, GL/CS contained no recommendation or vague recommendation for long-term follow-up for 7 of the conditions. Of the 24 conditions with recommendations for follow-up, 3 had recommendations for imaging follow-up only without mention of clinical follow-up. Of the 33 GL/CS reviewed, 17 made any recommendations about long-term follow-up. When recommendations were made regarding follow-up, they were often vague, using terminology such as "as needed".
Conclusions: Half of GL/CS fail to provide recommendations for clinical follow-up of common cardiovascular conditions. Writing groups for GL/CS should adopt a standard of routinely including recommendations for follow-up including specific advice about level of expertise needed (eg, primary care physician, cardiologist), need for imaging or testing, and frequency of follow-up.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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