目的:这项调查调查了社区和医院环境中的利钠肽(NP)测试,评估意识,可访问性,和利用。
结果:这项由研究者发起的调查,在欧洲心脏病学会的HFA中构思,包括14个问题。它经过了验证和试点测试,以确保问题的可读性和在线系统功能。这项调查已经进行了87天,从2023年4月5日至2023年7月1日通过网络平台。来自99个国家的751名医疗保健专业人员做出了回应。其中,92.5%的人可以在医院进行NPs检测,而34.3%的人在社区环境中无法使用NTproBNP。获得护理点NP测试并不常见(9.6%)。在31.0%的案例中,公共保险完全涵盖了NPs测试,私人保险提供37.9%的保险。大多数(84.0%)的参与者认为支持NPs检测的医学证据是强有力的,54.7%的人认为它具有成本效益。此外,35.8%找到了访问权限,意识,并采用有利于在医院和社区环境中进行NP测试。优化NP测试的策略涉及定期指南更新(57.9%),将NPs测试优先用于呼吸困难评估(36.4%),并引入临床医生反馈机制(21.2%)。值得注意的是,40%的患者缺乏基于社区的HF诊断途径,无法将高NP患者转诊为超声心动图和心脏病学评估。
结论:这项调查揭示了NP意识,access,并在多个国家采用。强调基于社区的早期心力衰竭诊断和优化HF诊断途径的重要性仍然至关重要,改善患者预后的未满足机会。
OBJECTIVE: This survey investigates natriuretic peptide (NP) testing in community and hospital settings, assessing awareness, accessibility, and utilization.
RESULTS: This investigator-initiated survey, conceived within the HFA of the European Society of Cardiology, comprised 14 questions. It underwent validation and pilot testing to ensure question readability and online system functionality. The survey was accessible for 87 days, from 5 April 2023 to 1 July 2023 via a web platform. There were 751 healthcare professionals across 99 countries who responded. Of them, 92.5% had access to NPs testing in hospital whereas 34.3% had no access to NTproBNP in community settings. Access to point of care NP testing was uncommon (9.6%). Public insurance fully covered NPs testing in 31.0% of cases, with private insurance providing coverage in 37.9%. The majority (84.0%) of participants believed that the medical evidence supporting NPs testing was strong, and 54.7% considered it cost-effective. Also, 35.8% found access, awareness, and adoption to be in favour of NPs testing both in hospital and community settings. Strategies to optimize NP testing involved regular guideline updates (57.9%), prioritizing NPs testing for dyspnoea assessment (36.4%), and introducing clinician feedback mechanisms (21.2%). Notably, 40% lacked a community-based HF diagnostic pathway for referring high-NP patients for echocardiography and cardiology evaluation.
CONCLUSIONS: This survey reveals NP awareness, access, and adoption across several countries. Highlighting the importance of community-based early heart failure diagnosis and optimizing HF diagnostic pathways remains a crucial, unmet opportunity to improve patient outcomes.