Difficultés ressenties face à la prise en charge de l’insuffisance cardiaque en médecine générale en Gironde en fonction de l’accès aux soins, en 2017

Abstract : Background: heart failure (HF) is a complex, serious and an increasingly frequent disease. In spite of regularly updated guidelines, its management in general medicine remains difficult and heterogeneous. In our Gironde’s department, the access to healthcare can be more complicated in some areas. Aim: the main objective of our study is to compare the relevance of care of the HF by general practitioners (GP) in Gironde according to theirs conditions of access to healthcare, in 2017. Methods: we performed a declarative and retrospective investigation with the GP in Gironde, with an online questionnaire, spread by the CDOM. Results: 129 doctors answered out of a total initial of 1541: the rate of answer is 8,4 %. All the age brackets are represented. Over half of the doctors qualify the access to the cardiologist as intermediary or difficult. The follow-up of the patients seems very regular (82 % of the doctors declare to follow every 2 months at least these patients). 57 % of the doctors say that they don’t make distinction of care between the 2 kinds of HF. As for the reference treatment of the altered HF: 77 % of the doctors answered ACEI, 53 % beta-blockers, 40 % MRAs but only 22 % consider the tritherapy as reference. There is no correlation between the isolated or not isolated medical environment, and the relevance care of the HF by GP. However, there is a link between the relevance of the care and the degree of autonomy felt to manage these patients as well as the level of current knowledge of this disease. There is also a correlation between the felt difficulties and the conditions of access to healthcare. Conclusion: the difficulties of access to healthcare don’t seem to influence the relevance of management of the HF by GP in Gironde in 2017. The medical desertification doesn’t seem to be the main factor susceptible to explain the difficulties of care of the HF in general medicine.
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Master Thesis
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Carole Genève. Difficultés ressenties face à la prise en charge de l’insuffisance cardiaque en médecine générale en Gironde en fonction de l’accès aux soins, en 2017 . Médecine humaine et pathologie. 2017. ⟨dumas-01636654⟩

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