Heart failure guidelines not followed by most GPs

When 451 Dutch GPs were presented with multiple choice options for treating an imaginary patient with heart failure and reduced ejection fraction (HF-REF) at four consecutive encounters, none took four optimal decisions recommended by clinical practice guidelines, which the authors conceded were “ambiguous or unclear”.

Only 7% considered stopping statin treatment – irrespective of the absence of side effects – despite recent insights that statins have only a neutral effect in patients with HF-REF.

“Numerous participating GPs may have been reluctant to stop statins when a patient feels comfortable with them,” the authors stated.

“We think, however, that continuing a drug that is not shown to be beneficial is a waste of money.

“Particularly in patients with HF-REF where polypharmacy is often seen, careful medication management is justified in order to prevent harm or interactions.”