Contemporary aetiologies, types and medication prescription patterns for chronic heart failure followed up at the Douala General Hospital

CaHReF 20116, Yaoundé Conges hall, 23 – 26 August 2016 , PL107

Heart failure(HF) is a clinical syndrome associated with significant morbidity and mortality globally,especially in low income countries like Cameroon. Early identification of underlying cause,type of heart failure and management has been shown to improve outcome and survival.

This study aimed to describe the contemporary aetiologies, types and pattern of medication prescription for chronic heart failure(CHF) in Douala General Hospital

This was a cross sectional hospital based study conducted at the cardiology outpatient department of Douala General Hospital. 282 medical records (2008-2015) and 79 patients (December 2015-February 2016) with heart failure were recruited. Medical history, laboratory investigations, electrocardiography and medication prescription were recorded on an adapted questionnaire. Data collected was analysed using SPSS version 20

361 patients participated in this study.The mean age was 66.6+/-13.4 years with 54.4% of females. The main aetiologies of heart failure were hypertensive cardiomyopathy 41.1%,dilated cardiomyopathy 33.8%,valvular heart disease 19.1% and ischaemic heart disease 1.9%.57.5% had heart failure with reduced ejection fraction (HFREF) while 42.5% had heart failure with preserved ejection fraction (HFPEF).Commonly prescribed medications for chronic heart failure patients included: loop diuretics (95.6%),Angiotensin converting enzyme inhibitors (ACEIs;84.5%),aldosterone receptor blocker(61.2%),digoxin (26.9%),beta blockers (16.3%),Angiotensin receptor blocker (14.7%).Over an 8year span(2008-2016) there has been a significant upward trend in the prescription of diuretics and ACEIs,but only a slight increase in beta blockers. Compared to those with HFPEF,a significant proportion of HFREF(69.2%) at p<0.00 were prescribed beta blockers, spironolactone and digoxin. Only about 6.4% of CHF were on targeted dosages for medications prescribed
Regardless of aetiology,more than half of participants had heart failure with reduced ejection fraction. Contrary to recommendations,there is therapeutic inertia in use of beta blockers and about 1 in 20 patients with heart failure had optimal medication dosages. Thus,the need for establishing national and local guidelines to facilitate the management of heart failure.

Contemporary aetiologies, heart failure, medication prescription