An approach to heart failure for the public-sector primary care clinician
Heart failure poses a significant global health challenge, with a considerable burden in Africa, where the annual mortality rate stands at 34%, twice the global average. Patients suffering from acute heart failure occupy numerous beds at the district level, and only a limited number can be referred...
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| Format: | Article |
| Language: | English |
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AOSIS
2025-06-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/6126 |
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| author | Liezel Rossouw Anthony S. Lachman Klaus B. von Pressentin |
| author_facet | Liezel Rossouw Anthony S. Lachman Klaus B. von Pressentin |
| author_sort | Liezel Rossouw |
| collection | DOAJ |
| description | Heart failure poses a significant global health challenge, with a considerable burden in Africa, where the annual mortality rate stands at 34%, twice the global average. Patients suffering from acute heart failure occupy numerous beds at the district level, and only a limited number can be referred for further evaluation and imaging at secondary or tertiary care facilities. Patients rely on their primary care physicians for the diagnosis and management of heart failure, as well as for identifying those who would benefit from referral to cardiology and formal echocardiography. This article discusses the significance of the new heart failure guidelines within the South African primary care public setting. It emphasises the importance of identifying risk factors and considers the value of access to family physicians, outreach clinic doctors, training on available adult primary care guidelines and telemedicine-supported cardiac ultrasound. Optimal medical therapy, which includes angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and spironolactone, has been shown to reduce readmissions and mortality rates. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a potent addition to conventional therapy and are currently being considered for inclusion in the National Essential Medicines List. Patients admitted to the hospital should not be discharged while experiencing persistent congestion, as this is associated with an increased risk of rehospitalisation, mortality and higher healthcare costs. Comprehensive patient education regarding medications, thorough follow-up during the six weeks post-discharge and linkage to primary healthcare are associated with decreased hospitalisation rates and improved outcomes. |
| format | Article |
| id | doaj-art-f077ad7dd72a4643b8bafc4e4e8292de |
| institution | Kabale University |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-f077ad7dd72a4643b8bafc4e4e8292de2025-08-20T03:47:10ZengAOSISSouth African Family Practice2078-61902078-62042025-06-01671e1e810.4102/safp.v67i1.61264953An approach to heart failure for the public-sector primary care clinicianLiezel Rossouw0Anthony S. Lachman1Klaus B. von Pressentin2Division of Family Medicine and Primary Care, Stellenbosch University, Cape TownPrivate Practice, Cardiology, Cape TownDivision of Family Medicine, Department of Family, Community and Emergency Care, University of Cape Town, Cape TownHeart failure poses a significant global health challenge, with a considerable burden in Africa, where the annual mortality rate stands at 34%, twice the global average. Patients suffering from acute heart failure occupy numerous beds at the district level, and only a limited number can be referred for further evaluation and imaging at secondary or tertiary care facilities. Patients rely on their primary care physicians for the diagnosis and management of heart failure, as well as for identifying those who would benefit from referral to cardiology and formal echocardiography. This article discusses the significance of the new heart failure guidelines within the South African primary care public setting. It emphasises the importance of identifying risk factors and considers the value of access to family physicians, outreach clinic doctors, training on available adult primary care guidelines and telemedicine-supported cardiac ultrasound. Optimal medical therapy, which includes angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and spironolactone, has been shown to reduce readmissions and mortality rates. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a potent addition to conventional therapy and are currently being considered for inclusion in the National Essential Medicines List. Patients admitted to the hospital should not be discharged while experiencing persistent congestion, as this is associated with an increased risk of rehospitalisation, mortality and higher healthcare costs. Comprehensive patient education regarding medications, thorough follow-up during the six weeks post-discharge and linkage to primary healthcare are associated with decreased hospitalisation rates and improved outcomes.https://safpj.co.za/index.php/safpj/article/view/6126heart failurecardiac failureprimary carepublic sectorprimary care clinicianheart failure managementprimary healthcareclinical approachheart failure guidelinespublic healthprimary care practicedistrict hospitaldistrict level. |
| spellingShingle | Liezel Rossouw Anthony S. Lachman Klaus B. von Pressentin An approach to heart failure for the public-sector primary care clinician South African Family Practice heart failure cardiac failure primary care public sector primary care clinician heart failure management primary healthcare clinical approach heart failure guidelines public health primary care practice district hospital district level. |
| title | An approach to heart failure for the public-sector primary care clinician |
| title_full | An approach to heart failure for the public-sector primary care clinician |
| title_fullStr | An approach to heart failure for the public-sector primary care clinician |
| title_full_unstemmed | An approach to heart failure for the public-sector primary care clinician |
| title_short | An approach to heart failure for the public-sector primary care clinician |
| title_sort | approach to heart failure for the public sector primary care clinician |
| topic | heart failure cardiac failure primary care public sector primary care clinician heart failure management primary healthcare clinical approach heart failure guidelines public health primary care practice district hospital district level. |
| url | https://safpj.co.za/index.php/safpj/article/view/6126 |
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