Pharmacological Trials on Heart Failure: What Can We Translate into Daily Clinical Practice?
Adherence to evidence-based medicine is the accepted goal to which doctors should aspire in their clinical practice. In the last 20 years, large-scale controlled trials have been conducted in patients with chronic heart failure. These trials used clinically important outcome measures including death and major morbid events. The assignment of patients to treatments was randomized, the number of patients was adequate, and the follow-up was complete and reasonably long in order to provide the required number of events to generally ensure the necessary statistical power for unequivocal interpretation of the results. Accordingly, there is now evidence on the safety and efficacy of a variety of treatments for heart failure. However, a number of clinical surveys in various countries, both in primary care and in hospital practice, revealed that a significant proportion of eligible patients are not receiving treatments that would increase both the quality and the length of their life. If under-treatment can have an adverse economic effect in terms of increased hospitalizations, incorporating these results into clinical practice would reduce the burden on health care systems . Despite these obvious considerations, however, it appears that translation of the trial results into clinical practice has often been slow and incomplete.
KeywordsHeart Failure Chronic Heart Failure Daily Clinical Practice Important Outcome Measure Heart Failure Diagnosis
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