Clinical Inertia in Terms of Recurrent Hospitalization in the Treatment of Heart Failure Between General Physicians and Cardiologists

Abstract

Cardiologists are more likely to use clinical guideline-supported therapies than general physicians, a fact that has been shown to reduce readmissions. Objective: To compare the intensification of heart failure treatment and its course with re-hospitalization among general physicians and cardiologists at a tertiary care hospital. Methodology: An observational cross-sectional study was conducted in the cardiology inpatient department of a tertiary care hospital from June 2023 to December 2023 for six months. All patients admitted with acute decompensated heart failure with reduced ejection fraction were included. The treatment prescriptions that they had been followed before the event were noted along with the fact that whether they were treated by a cardiologist or a general physician, and their compliance with medical treatment was recorded. Frequencies and percentages were computed for qualitative variables. Results: A statistically significant association of re-admission was observed among cardiologists (1.40 ± 0.57) compared to general physicians (2.54 ± 0.57; p<0.001). Almost 100% of cardiologists advised beta blockers as compared to their prescription by 42% of general physicians. All cardiologists advised ARBS/ACE inhibitors as compared to 58% of general physicians. 90% of cardiologists advised aldosterone receptor antagonists as compared to 10% of general physicians. Only 12% of cardiologists advised SGLT-2 inhibitors as compared to 88% of physicians. Overall, 36% of cardiologists recommended guideline-mediated therapy while 12% of general physicians recommended guideline-mediated therapy. Conclusions: Cardiologist care is significantly associated with reduced re-admissions among patients re-admitted after heart failure treatment.