Published Papers - Abstract 285

Humphreyes-Reid L, Stewart S, Russell A & Dobson A. Does specialist management of congestive heart failure make a difference: A cross-sectional survey from the Australian Longitudinal Study on Women's Health? British Medical Journal, 2006; :

Objective: To investigate the extent to which the management of older Australian women with congestive heart failure (CHF) departs from the recommended clinical guidelines and to determine if specialist intervention influences adherence to these guidelines.Design: Cross-sectional survey Setting: Community settings across rural and urban Australia.Participants: A random sample of women aged 78-83 enrolled in the Australian Longitudinal Study on Women’s Health who reported having heart disease or symptoms.Outcome measures: Participant reports of clinical history and current pharmacological and nonpharmacological management of CHF.Results: Of 1162 women in the study, 507 met our criteria for CHF. Only 26% of these women were on an angiotensin-converting enzyme inhibitor or angiotensin II type-1 receptor blocker in combination with a beta-blocker, with or without diuretic therapy. Pharmacological management was not significantly different for women who did or did not see a specialist.Except for regular medical appointments, managing medications, dyspnoea and following a low fat diet, less than 50% of women reported receiving advice on managing their heart failure. Women who saw a specialist were significantly more likely to receive advice on exercise, salt restriction, fluid restriction, alcohol intake, weighing themselves, swollen ankles, managing medications, regular medical appointments and when to get medical advice outside scheduled appointments. Conclusion: Specialist management improves some aspects of management in older Australian women with CHF but a large gap remains between actual and optimal management.