Description of a chronic heart failure service model and review of pharmacotherapy in a district general hospital in comparison to Scottish Intercollegiate Guideline Network (SIGN) guidelines.
BACKGROUND
The Scottish Intercollegiate Guidelines Network (SIGN) guideline 95 on the management of chronic heart failure (CHF) was published in February 2007, superseding SIGN guideline 35 of February 1999. The guideline promotes evidence based management of CHE.


OBJECTIVE
To describe an existing service model and to review our level of concordance with SIGN guidelines.


METHODS
We describe a model of a CHF service based in a district general hospital (DGH) in Scotland. We conducted a retrospective review on consecutive new referrals between August and November 2002, and a prospective review of new attendances between September 2005 and January 2006.


RESULTS
In 2002 and 2005/6, 49 and 45 patients were reviewed respectively, with 26 and 28 patients showing left ventricular systolic dysfunction on echocardiography. Median ages of patients were 81 and 79 years respectively. Angiotensin Converting Enzyme Inhibitor (ACEI) or Angiotensin II Receptor Blocker (AIIRB) therapy was in use in 23 (88.5%) and 24 (85.7%) patients respectively. The use of beta-blockers, digoxin and spironolactone was shown to have improved between both reviews.


CONCLUSIONS
We have been able to demonstrate an improving level of concordance with SIGN guidelines in a district general hospital (DGH) heart failure service model run by care of the elderly physicians and supported by specialist nurses.
Ogundipe
O A
OA
Department of Medicine for the Elderly, Borders General Hospital, Melrose, Roxburghshire, TD6 9BS. ola_ayodele@hotmail.com
Cordina
J
J
Norris
C A
CA
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004077:Digoxin / Q000627:therapeutic use; D019468:Disease Management; D004232:Diuretics / Q000627:therapeutic use; D054143:Heart Failure, Systolic / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008485:Medical Audit; D010044:Outpatient Clinics, Hospital; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D013148:Spironolactone / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D013148:Spironolactone; D004077:Digoxin