Physician Attitudes Toward End-Stage Heart Failure

A National Survey

Paul Hauptman, Jason Swindle, Zainal Hussain, Lois Biener, Thomas E. Burroughs

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Background: Despite recent improvements in medical therapies, heart failure remains a prevalent condition that places significant burdens on providers, patients, and families. However, there is a paucity of data published describing physician beliefs about heart failure management, especially in its advanced stages. Methods: In order to better understand physician decision-making in end-stage heart failure, we used a stratified random sampling of physicians obtained from the Master File of the American Medical Association to survey cardiologists (n = 600), geriatricians (n = 250), and internists/family practitioners (n = 600). Results: Response rate was 59.6% (highest among geriatricians). The vast majority (>90%) of respondents cited similarities between the clinical trajectory of end-stage heart failure and lung cancer or chronic obstructive pulmonary disease; however, only 15.7% stated that they could predict death at 6 months "most of the time" or "always." Inpatient volume was a predictor of confidence in predicting mortality (odds ratio = 1.38, 95% confidence interval, 1.36-1.40). Less than one quarter of respondents formally measure quality of life. The experience with deactivation of implantable cardioverter defibrillators was limited: 59.8% of cardiologists, 88.0% of geriatricians, and 95.1% of internal medicine/family practice physicians have had 2 or fewer conversations with patients and families about this option. Conclusions: Significant gaps in knowledge about and experience with end-stage heart failure exist among a large proportion of physicians. The growing prevalence and highly symptomatic nature of heart failure highlight the need to further evaluate and improve the way in which care is delivered to patients dying from the disease.

Original languageEnglish (US)
Pages (from-to)127-135
Number of pages9
JournalAmerican Journal of Medicine
Volume121
Issue number2
DOIs
StatePublished - Feb 1 2008
Externally publishedYes

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Heart Failure
Physicians
Heart Neoplasms
Implantable Defibrillators
Family Practice
Family Physicians
American Medical Association
Internal Medicine
Chronic Obstructive Pulmonary Disease
Surveys and Questionnaires
Inpatients
Lung Neoplasms
Decision Making
Odds Ratio
Quality of Life
Confidence Intervals
Mortality
Geriatricians
Cardiologists
Therapeutics

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Physician Attitudes Toward End-Stage Heart Failure : A National Survey. / Hauptman, Paul; Swindle, Jason; Hussain, Zainal; Biener, Lois; Burroughs, Thomas E.

In: American Journal of Medicine, Vol. 121, No. 2, 01.02.2008, p. 127-135.

Research output: Contribution to journalArticle

Hauptman, Paul ; Swindle, Jason ; Hussain, Zainal ; Biener, Lois ; Burroughs, Thomas E. / Physician Attitudes Toward End-Stage Heart Failure : A National Survey. In: American Journal of Medicine. 2008 ; Vol. 121, No. 2. pp. 127-135.
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