Adherencia a la guía de práctica clínica para el manejo hospitalario de pacientes con insuficiencia cardíaca descompensada en una unidad de cuidados coronarios de Colombia

Juan José Diaztagle Fernández; Diana Vargas Vergara; Carlos Alfonso Madariaga Carocci; David Hamon-Rugeles; Juan Pablo Castañeda-González

doi:10.47487/apcyccv.v4i4.330

Authors

Juan José Diaztagle Fernández Departamento de Medicina Interna, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia. https://orcid.org/0000-0002-0320-8304
Diana Vargas Vergara Departamento de Cardiología, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia. https://orcid.org/0000-0002-2090-6921
Carlos Alfonso Madariaga Carocci Departamento de Medicina Interna, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia. https://orcid.org/0000-0001-6055-5188
David Hamon-Rugeles Departamento de Medicina Interna, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia. https://orcid.org/0000-0002-7424-0758
Juan Pablo Castañeda-González Instituto de Investigaciones, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia. https://orcid.org/0000-0001-5400-9068

DOI:

https://doi.org/10.47487/apcyccv.v4i4.330

Keywords:

Heart Failure, Medication Adherence, Coronary Care Units, Clinical Practice Guidelines

Abstract

Objective. To assess adherence to the recommendations for the diagnosis and management of hospitalized patients with Decompensated Heart Failure issued by the European Society of Cardiology in 2021 at a Coronary Care Unit at a fourth-level hospital in the city of Bogotá. Materials and methods. A descriptive cross-sectional study was conducted, including hospitalized patients in the Coronary Care Unit at Hospital San José in Bogotá, with a primary diagnosis of Decompensated Heart Failure, from September 2021 to January 2023. Patient data were collected from medical records. Adherence to the Decompensated Heart Failure guidelines was described in the study. Results. High adherence was observed for laboratory tests and medication prescriptions recommended by the 2021 European Society of Cardiology guidelines. However, there was low adherence to the request for thyroid function tests, troponin, and iron studies. The cause of heart failure and decompensation was adequately recorded. The most common cause of decompensation was acute coronary syndrome. Regarding the hemodynamic profile on admission, the majority presented as Stevenson B. Pharmacological adherence to Class I recommendations showed high compliance in prescribing beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and Angiotensin Receptor-Neprilysin Inhibitors. However, lower adherence was observed for Sodium-glucose co-transporter two inhibitors and Mineralocorticoid receptor antagonists. Conclusions. Variable adherence rates were recorded, emphasizing satisfactory compliance with class I recommendations for certain medications and laboratory tests. It is necessary to improve adherence in the request for paraclinicals, especially in thyroid function tests and ferrokinetic profiles.

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