Please use this identifier to cite or link to this item: https://hdl.handle.net/10137/7678
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dc.contributor.authorMu, Monicaen
dc.contributor.authorMajoni, Sandawana Williamen
dc.contributor.authorIyngkaran, Pupalanen
dc.contributor.authorHaste, Marken
dc.contributor.authorKangaharan, Nadarajahen
dc.date2018en
dc.date.accessioned2019-07-02T06:47:55Zen
dc.date.available2019-07-02T06:47:55Zen
dc.date.issued2019-07en
dc.identifier.citationHeart, lung & circulation 2019-07; 28(7): 1042-1049en
dc.identifier.urihttps://hdl.handle.net/10137/7678en
dc.description.abstractHeart failure (HF) is associated with significant morbidity and mortality and recurrent hospitalisations, particularly in the Indigenous Australians of the Northern Territory. In remote Northern Australia, the epidemiology is less clear but anecdotal evidence suggests it may be worse. In addition, some anecdotal evidence suggests that prognostic pharmacological therapy could also be underutilised. Minimal HF data exists in the remote and Indigenous settings, making this study unique. A retrospective cohort review of pharmacological management of 99 patients from 1 January 2014 to 31 December 2014 was performed. Ninety-nine (99) patients were identified. 59.6% were non-Indigenous vs 40.4% Indigenous. The majority was male (69.7%). Indigenous patients were younger; median age was 51.4 (43.4-60.6) vs 70.5 (62.2-77.0), p<0.001. Major causes of HF were coronary artery disease (61%) and dilated cardiomyopathy (27%). Associated comorbidities included hypertension (52%), dyslipidaemia (38%), diabetes mellitus (40%) and atrial fibrillation (25%). The use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) and β-blocker was 68% and 87%, respectively. Forty-one (41) patients not on an ACEI/ARB and/or β-blocker were identified. Seventeen (17) of those patients (42%) did not receive an ACEI/ARB because of renal failure. Four (4) patients (10%) did not take a β-blocker due to hypotension. Fourteen (14) patients (34%) were not prescribed an ACEI/ARB and/or β-blocker had no identifiable contraindications. Indigenous patients are over-represented at a younger age demonstrating the alarming rate of disease burden in NT's young Indigenous population. Generally, ACEI/ARBs were underutilised compared to β-blockers with renal impairment being the primary contraindication. There is a need to develop processes to further improve the use of heart failure medications and setting up a HF database could be the first step in progress.en
dc.language.isoengen
dc.subjectAustraliaen
dc.subjectHeart failureen
dc.subjectIndigenous populationen
dc.subjectTreatment guidelinesen
dc.titleAdherence to Treatment Guidelines in Heart Failure Patients in the Top End Region of Northern Territory.en
dc.typeJournal Articleen
dc.identifier.journaltitleHeart, lung & circulationen
dc.identifier.doi10.1016/j.hlc.2018.06.1038en
dc.identifier.pubmedidhttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed//29980453en
dc.identifier.affiliationNorthern Territory Medical Program, Flinders University, Royal Darwin Hospital, Tiwi, NT, Australia. Electronic address: monica.mu@live.com.au..en
dc.identifier.affiliationNorthern Territory Medical Program, Flinders University, Royal Darwin Hospital, Tiwi, NT, Australia; Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Tiwi, NT, Australia; Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia..en
dc.identifier.affiliationHeartWest, Melbourne, Vic, Australia; Northern Territory Medical School, Flinders University, Tiwi, NT, Australia..en
dc.identifier.affiliationDepartment of Cardiology, Division of Medicine, Royal Darwin Hospital, Tiwi, NT, Australia..en
dc.identifier.affiliationNorthern Territory Medical Program, Flinders University, Royal Darwin Hospital, Tiwi, NT, Australia; Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia; Department of Cardiology, Division of Medicine, Royal Darwin Hospital, Tiwi, NT, Australia..en
dc.identifier.pubmedurihttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed//29980453en
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