PRIMARY-HF: Heart Failure Screening in Primary Care using Point-of-Care.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Acta medica portuguesa Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI:10.20344/amp.22463
Jonathan Dos Santos, João Pedro Nobre, João Pedro Ferreira, Maria Inês M Marques, Miguel Henriques, Nuno Cardim, Tiago Villanueva, Alexandra Gonçalves
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Abstract

Introduction: Heart failure is a major health challenge with high morbidity and socioeconomic burden, especially when diagnosis is delayed. In primary care, HF detection can be challenging due to symptoms overlapping with other conditions, limited access to diagnostic tools, and resource constraints. This study explores the use of natriuretic peptides (NT-proBNP) and point-of-care ultrasound (POCUS) with artificial intelligence integration as tools to improve HF screening and management in primary care. This study aims to determine whether NT-proBNP testing alone or combined with cardiac POCUS improves heart failure diagnosis and management in primary care settings, and to evaluate the cost-effectiveness of this approach.

Methods: This randomized controlled trial will involve patients aged 50 or older with suspected HF or cardiovascular risk factors, recruited across four primary care centers. Participants will be randomly assigned to one of four groups: standard of care (SoC), SoC with NT-proBNP, SoC with NT-proBNP and POCUS, and SoC with POCUS. Primary outcomes include new HF diagnosis, initiation of guideline-directed medical therapy, and improvement in health-related quality of life. Secondary outcomes include cost-effectiveness and the quality assessment of POCUS performed by trained primary care physicians. The integration of NT-proBNP and POCUS in primary care may enhance early heart failure diagnosis, optimize therapy, improve patient quality of life, and reduce healthcare costs associated with heart failure misdiagnosis and delayed treatment. This study could support the broader adoption of accessible diagnostic tools to improve heart failure management in primary care.

Primary - hf:使用护理点的初级保健心衰筛查。
心衰是一种主要的健康挑战,具有高发病率和社会经济负担,特别是当诊断延迟时。在初级保健中,由于症状与其他疾病重叠、诊断工具的获取有限以及资源限制,HF检测可能具有挑战性。本研究探讨了将利钠肽(NT-proBNP)和护理点超声(POCUS)与人工智能相结合,作为改善初级保健中心衰筛查和管理的工具。本研究旨在确定NT-proBNP检测单独或联合心脏POCUS是否能改善初级保健机构的心力衰竭诊断和管理,并评估这种方法的成本效益。方法:这项随机对照试验将纳入来自四个初级保健中心的年龄在50岁及以上、疑似心衰或心血管危险因素的患者。参与者将被随机分配到四组中的一组:标准护理组(SoC)、NT-proBNP组、NT-proBNP和POCUS组以及POCUS组。主要结局包括新的心衰诊断,指导药物治疗的开始,以及健康相关生活质量的改善。次要结果包括由训练有素的初级保健医生进行POCUS的成本效益和质量评估。NT-proBNP和POCUS在初级保健中的整合可以增强心力衰竭的早期诊断,优化治疗,改善患者的生活质量,并降低与心力衰竭误诊和延迟治疗相关的医疗成本。这项研究可以支持更广泛地采用可获得的诊断工具来改善初级保健中的心力衰竭管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta medica portuguesa
Acta medica portuguesa MEDICINE, GENERAL & INTERNAL-
CiteScore
1.90
自引率
16.70%
发文量
256
审稿时长
6-12 weeks
期刊介绍: The aim of Acta Médica Portuguesa is to publish original research and review articles in biomedical areas of the highest standard, covering several domains of medical knowledge, with the purpose to help doctors improve medical care. In order to accomplish these aims, Acta Médica Portuguesa publishes original articles, review articles, case reports and editorials, among others, with a focus on clinical, scientific, social, political and economic factors affecting health. Acta Médica Portuguesa will be happy to consider manuscripts for publication from authors anywhere in the world.
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