title: Perspectives of Primary-Care Providers on Heart Failure in Long-Term Care Homes.
abstract: Heart failure (HF) is common among long-term care (LTC) residents, and may account for 40 per cent of acute-care transfers. Canadian Cardiovascular Society HF guidelines endorse standard therapies; yet LTC residents are less likely to receive treatment. This qualitative study employed focus groups to explore perceptions, from 18 physicians and nurse practitioners in three Ontario homes, on HF care practices and challenges. For example, participants reported challenges with HF diagnostic skills and procedural knowledge. They also identified the need for interprofessional collaboration and role clarification to improve HF care and outcomes. To address these challenges, multimodal interventions and bedside teaching are required. Leadership was viewed as essential to improve HF care. Several concerns arose regarding knowledge gaps and clinical deficits among primary-care providers who manage heart failure in LTC residents. Multimodal, clinically focused educational and interprofessional solutions are needed to improve HF care in long-term care.
authors.affiliation: Research Institute for Aging and School of Public Health and Health Systems,University of Waterloo.
authors.forename: George A
authors.initials: GA
authors.lastname: Heckman
authors.affiliation: Conestoga College.
authors.forename: Veronique M
authors.initials: VM
authors.lastname: Boscart
authors.affiliation: Population Health Research Institute,McMaster University.
authors.forename: Robert S
authors.initials: RS
authors.lastname: McKelvie
authors.affiliation: Institute for Work & Health,Toronto.
authors.forename: Teresa
authors.initials: T
authors.lastname: D'Elia
authors.affiliation: University of Waterloo.
authors.forename: Osman
authors.initials: O
authors.lastname: Osman
authors.affiliation: Faculty of Health Sciences,McMaster University.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kaasalainen
authors.affiliation: School of Social Work,Lakehead University.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Kelley
authors.affiliation: Department of Psychiatry & Behavioural Neurosciences,McMaster University.
authors.forename: Carrie
authors.initials: C
authors.lastname: McAiney
authors.affiliation: School of Public Health and Health Systems,University of Waterloo.
authors.forename: Paul
authors.initials: P
authors.lastname: Stolee
authors.affiliation: Faculty of Health Sciences,McMaster University.
authors.forename: Patricia
authors.initials: P
authors.lastname: Strachan
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D011320:Primary Health Care