Management of heart failure in The Netherlands.
In The Netherlands, the incidence and prevalence of heart failure are rising as is the case in most other European countries. Overall, there are 200,000 patients with heart failure in The Netherlands and around 25,000 hospitalisations annually with a discharge diagnosis of heart failure. Most of these patients are managed in primary care, often together with a cardiologist. There is an active guideline program in different professional organisations (e.g. general practitioners, cardiologists) and in 2002 a collaborative multidisciplinary guideline for management of chronic heart failure was developed. However, there is clearly room for improvement in the adherence to these guidelines both with regard to the diagnosis and the treatment of HF patients. For example, ACE-I and beta-blockers are still under-prescribed. In particular, the more severely ill patients seem to be under treated. At present, general practitioners and cardiologists differ in their views on heart failure, resulting in differences in diagnosis and management. In addition to the multidisciplinary guidelines, several other initiatives have been developed to improve outcomes in these patients, such as rapid access clinics and outpatient heart failure clinics.
Jaarsma
Tiny
T
Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands. t.jaarsma@thorax.umcg.nl
Haaijer-Ruskamp
Flora M
FM
Sturm
Heidrun
H
Van Veldhuisen
Dirk J
DJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002309:Cardiology; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005194:Family Practice; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D009426:Netherlands / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D015995:Prevalence; D013148:Spironolactone / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D013148:Spironolactone; D004077:Digoxin