Neither doctors nor patients are particularly accurate at assessing the risk of advanced heart failure (HF), according to new research. Physicians tend to overestimate the risk, while patients dramatically underestimate it.
For this reason, suggested lead author Amrut V. Ambardekar, MD, an assistant professor in the division of cardiology at the University of Colorado, it is even more important for patients to receive early education about treatment options.
The study, published Aug. 16 in JACC: Heart Failure, analyzed 161 ambulatory patients enrolled in 11 advanced HF-transplant cardiology centers from May 17, 2013 to October 31, 2015.
Doctors considered 69 percent of the patients at high risk for transplant, left ventricular assist device (LVAD) or death within one year, while only 14 percent of the patients considered themselves to be at high risk.
Over 13 months of follow-up, 38 percent of the patients experienced one of the outcomes: 21 percent deaths, 8 percent transplants and 9 percent LVAD implants.
“It was surprising that there were such drastic differences between patient perceptions and physician perceptions of heart failure disease severity,” Ambardekar said in a statement. “We hope better understanding these differences will facilitate improved patient-physician communication regarding advanced heart failure therapies.”
Researchers also found 77 percent of patients identified as high risk were willing to consider LVAD implantation, but 63 percent of those patients declined a feeding tube — a less aggressive form of therapy.
“More than likely, these inconsistencies indicate a poor understanding of these treatment options,” Ambardekar said. “Patients may not fully appreciate the invasive nature of some of these procedures, so we probably need to look for better ways to educate our patients both on the severity of their disease and their treatment options – well before they need these advanced therapies.”
To read an interview with Ambardekar describing the study in greater detail and offering recommendations based on his findings, click here.
Daniel joined TriMed’s Chicago editorial team in 2017 as a Cardiovascular Business writer. He previously worked as a writer for daily newspapers in North Dakota and Indiana.