Abstract
The 2022 national heart failure audit noted, "Older patients are less likely to access diagnostics, lifesaving drugs, and specialist care.” Additionally, there is evidence suggesting that they are less frequently initiated on disease-modifying drugs (DMD). The National Institute for Health and Care Excellence (NICE) supports the use of SGLT2 inhibitors for those with heart failure with reduced ejection fraction (HFrEF). However, this has recently expanded to those with preserved ejection fraction (HFpEF). This is significant for elderly heart failure patients as SGLT2 inhibitors offer a favourable side effect profile.
Our research was conducted in 2022 at a tertiary hospital. This research involved the analysis of thirty-eight heart failure patients that were admitted under the care of the geriatric medicine team. We investigated the initiation of diagnostics, the utilisation of DMDs and the coordination of post-discharge follow-up arrangements.
Our study revealed significant inconsistencies with the management of heart failure within this patient demographic. Notably, a substantial proportion of patients lacked prescriptions for DMDs, and the initiation of SGLT2 inhibitors was inadequate. Moreover, over 62% of patients did not receive scheduled follow-up appointments. We also found that a considerable number of patients missed essential diagnostic echocardiograms, which are critical for determining the appropriate DMD prescriptions.
These results highlight the urgent requirement for improved education and access to diagnostics and DMDs. We plan to share our findings at the forthcoming local geriatric meeting and aim to collaborate more closely with the cardiology department to enhance care quality and integration.