| Autor: |
George Villa, Wendy Gin-Sing, Rachel J. Davies, Luke Howard, Margaret Lau-Walker, Simon J.R. Gibbs, Geraldine Lee |
| Rok vydání: |
2017 |
| Předmět: |
|
| Zdroj: |
Pulmonary Circulation and Pulmonary Vascular Disease. |
| DOI: |
10.1183/1393003.congress-2017.pa3530 |
| Popis: |
The ESC/ERS pulmonary hypertension guidelines recommend reassessing response to treatment in all patients commenced on therapy for pulmonary arterial hypertension (PAH). One factor in this assessment is WHO Functional Class (FC), with a lack of improvement in FC pointing towards the need for an escalation of therapy. This audit of current practice in a UK national referral service looks at the use of therapies in these patients and attempts to ascertain the reasons why their treatment may or may not seem to be in concordance with current guidelines. Patients with a diagnosis of PAH in WHO FC III/IV on the census date of 31st January 2017 were identified from data collected in a prospective database, TRIPHIC. The medical records for the 242 patients were then accessed to determine the decisions regarding therapy. Of the patients who remained in FC III/IV, 22% were limited by co-morbidities rather than PAH. 20% were satisfied with their current status and declined further therapy and 19% of patients in whom a prostanoid infusion was clinically indicated refused it following informed discussion. 17% of patients had multiple co-morbidities and additional therapy was felt to be inappropriate following discussion at our MDT meeting. This audit highlighted several patients that are potentially undertreated according to WHO FC assessment, however, it also showed the high number of patients that do not want an increase to their therapy, in particular more invasive prostanoid therapy. Further research is underway to understand these reasons in more depth. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
