Management pathways after first symptom*, overall and by diagnosis source
| Management pathway after first HF symptom* | Management of patients with no HF prediagnosis symptoms† | |||||
| Pathway | Total | Primary care | Hospital | Total | Primary care | Hospital |
| n (%) | n (%) | n (%) | n(%) | n (%) | n (%) | |
|---|---|---|---|---|---|---|
| #1 (NICE) | 3555 (23.6) | 1636 (39.3) | 1919 (17.6) | 2336 (13.2) | 1118 (32.2) | 1218 (8.5) |
| #2 | 2753 (18.3) | 1267 (30.4) | 1486 (13.6) | 2026 (11.4) | 989 (28.5) | 1037 (7.3) |
| #3a | 926 (6.1) | 155 (3.7) | 771 (7.1) | 4012 (22.6) | 390 (11.2) | 3622 (25.4) |
| #3b | 2779 (18.5) | 374 (9.0) | 2405 (22.1) | |||
| #4 | 2166 (14.4) | 442 (10.6) | 1724 (15.8) | 2210 (12.5) | 361 (10.4) | 1849 (13.0) |
| #5 | 1522 (10.1) | 166 (4.0) | 1356 (12.4) | 2844 (16.0) | 250 (7.2) | 2594 (18.2) |
| #6 (none) | 1356 (9.0) | 125 (3.0) | 1231 (11.3) | 4296 (24.2) | 362 (10.4) | 3934 (27.6) |
| Total | 15 057 | 4165 | 10 892 | 17 724 | 3470 | 14 254 |
Definitions of pathways: #1: echo and/or BNP and referral (NICE); #2: echo and/or BNP but no referral; #3a: no echo, BNP or referral but put on a new medication (ACEI/ARB/HF-BB); #3b: no echo, BNP or referral but already on a medication (ACEI/ARB/HF-BB); #4: referral only; #5: other pathway (had some kind of management, eg, given ECG/smoking advice/influenza jab and already on or put on a beta-blocker); #6: no pathway followed.
p Value for χ2 test of independence between the proportions in primary care and hospital patients were all significant at 0.001.
*Where management came after the first symptomthat was recorded during the 5-year prediagnosis period (including the diagnosis date).
†Management recorded during the 5-year prediagnosis period (including the diagnosis date).
ACEI, ACE inhibitor; ARB, angiotensin II receptor blocker; BNP, B-type natriuretic peptide; HF, heart failure; HF-BB, HF-specific beta-blockers; NICE, National Institute for Health and Care Excellence.