The IMPROVEMENT study (IMprovement PROgram in eValuation and managEMENT of heart failure) - Rationale and design
Korewicki J., Tendera M., Browarek A., Zieliński T., Cleland JGF., Cohen Solal A., Cosin Aguilar J., Dietz R., Eastaugh J., Follath F., Freemantle N., Gavazzi A., van Gilst WH., Hobbs FDR., Korewicki J., Madeira HC., Preda I., Swedberg K., Widimski J., Cieśliński A., Dabrowski M., Kornacewicz-Jach Z., Krzemińska-Pakuła M., Opolski G., Poloński L., Rynkiewicz A., Wrabec K., Wysocki H.
Material and methods: The program consists of 3 phases: phase 1 - survey of knowledge and current practice of primary care medicine; phase II - educational programs based on the results of phase I; phase III - survey of knowledge and current practice improvement in primary care medicine after the completion of phase II educational activities. Results: Presented results are part of the international IMPROVEMENT study. The project was prepared and conducted by the Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. There were primary care physicians (PCP) from 14 countries taking part in this study and database comprised of 11 062 patients' medical records. About 47% of the participating PCP were in the age group 41-50 years and women constituted 50% of the whole group. In the majority of countries, physician recruited from the urban district represented 50% of all PCP. More than 50% of patients with heart failure were above 70 years of age. Most of the subjects presented with typical clinical symptoms (i.e. dyspnea) along with objective signs of HF. Conclusions: The etiology of heart failure was: coronary heart disease in 60%, hypertension with or without coronary heart disease in 50%, valvular heart disease in 15%, idiopathic congestive cardiomyopathy in 6% patients. Concomitant diabetes was found in 19%, bronchopulmonary disease - in 25% of patients with HF.