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Management of heart failure: an Italian national survey on fellows/specialists in geriatrics

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Abstract

Background

Heart failure (HF) is often managed by geriatricians. Few data are available on their knowledge and attitudes about this condition.

Aims

To compare perceptions and knowledge on HF of specialists/fellows in geriatrics working in Italy.

Methods

This nation-wide survey carried out by the Italian Society of Gerontology and Geriatrics in May–June 2019 enrolled 283 specialists/fellows in geriatrics in Italy. Results were stratified by qualification (specialist/fellow) and performance (lower/higher quartile of correct answers).

Results

About half (55.5%) of the participants worked in acute care wards, 190 were residents, and 93 specialists. The overall proportion of correct answers was 70.8%, with no differences between specialists and fellows. There was a poor knowledge, with no differences between groups, about the target doses of ACE-inhibitors (36% of correct answers), the pharmacological treatment of HF with preserved ejection fraction (HFpEF) (37% of correct answers), and the inotropes indicated in acute HF (35% of correct answers). Compared to specialists, fellows performed better on indication (88% vs 76%, P = 0.019) and mechanism of action (93% vs 84%, P = 0.023) of sacubitril/valsartan, and on therapeutic indications of patients with atrial fibrillation (92% vs 75%, P < 0.001).

Conclusions

Globally, there was a good knowledge of the latest guidelines on the diagnosis and management of HF. However, for some important topics, such as HFpEF, that is the most common HF manifestation in older adults, the observed performance was relatively poor, indicating the need for focused educational campaigns.

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Acknowledgements

We would like to acknowledge all the Directors of the Italian Internship programs in Geriatrics for their participation in the survey.

Funding

The study was not funded.

Author information

Authors and Affiliations

  1. Area di Geriatria, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128, Rome, Italy

    Diana Lelli, Claudio Pedone & Raffaele Antonelli Incalzi

  2. Dipartimento di Scienze Mediche Traslazionali, Università Degli Studi di Napoli “Federico II”, Via Pansini 5, 80131, Naples, Italy

    Dario Leosco

  3. Dipartimento di Malattie Cardiovascolari, endocrino-metaboliche ed invecchiamento, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy

    Graziano Onder

Authors
  1. Diana Lelli
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  2. Claudio Pedone
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  3. Dario Leosco
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  4. Graziano Onder
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  5. Raffaele Antonelli Incalzi
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Consortia

for the Società Italiana di Gerontologia e Geriatria

Contributions

CP, DL, GO and RAI contributed to the study conception and design. Data analysis were performed by DL and CP, and were interpreted by all the authors. The first draft of the manuscript was written by DL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Diana Lelli.

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Conflict of interest

The authors have no conflicts of interest to disclose.

Human and animal rights statement

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Being a survey, it did not require the Ethic Committee approval.

Informed consent

All the participants in the survey were informed on the objectives of study and that their participation will be considered a consent to their data treatment.

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All the authors have read the final version of the paper and have approved its submission and publication.

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Data are available on request.

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Lelli, D., Pedone, C., Leosco, D. et al. Management of heart failure: an Italian national survey on fellows/specialists in geriatrics. Aging Clin Exp Res 32, 2049–2055 (2020). https://doi.org/10.1007/s40520-020-01577-1

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  • DOI: https://doi.org/10.1007/s40520-020-01577-1

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