Most heart failure patients in India do not receive guideline-directed medical therapy (GDMT), considered the cornerstone of pharmacological care for such ailments, a nationwide survey of over 5,000 doctors has suggested.
Over half of the doctors surveyed reported that only one in four heart failure patients receive GDMT, a combination of medications that help relax the blood vessels, reduce fluid build-up, ease the heart’s workload and improve its pumping efficiency.
The guidelines recommended by leading cardiology societies — such as the American College of Cardiology, the American Heart Association and the European Society of Cardiology — are aimed at reducing premature mortality through standardised medications and diagnostic tests.
The Indian study found that nearly 4 in every 10 of the 5,012 respondents did not use a GDMT-prescribed diagnostic blood test, known as NT-proBNP, to measure a protein fragment that can help guide treatment and predict the course of the disease.
The study, by a nine-member panel of doctors with the Heart Failure Association of India, a professional body of cardiologists, is the first to examine heart failure treatment practices across the country. Its findings have bolstered concerns in medical circles about the limited adoption of GDMT in India.
Although GDMT highlights the importance of assessing patients’ quality of life during heart failure treatment, the survey found that only one in four respondents routinely evaluated patients’ quality of life through standardised questionnaires.
Around 58 per cent of the respondents cited high treatment costs and 54 per cent cited patients’ failure to adhere to prescribed medications as major barriers to delivering GDMT. Nearly 20 per cent also reported that unqualified doctors had stepped in and stopped heart failure medications for some patients.
“We hope our findings will lead to expanded adoption of GDMT and appropriate care for more heart failure patients,” Shantanu Sengupta, a cardiologist in Nagpur who led the study, told The Telegraph.