Aims We explored whether a missed cohort of patients in the community with heart failure (HF) and left ventricular systolic dysfunction (LVSD) could be identified and receive treatment optimization through a primary care heart failure (PCHF) service. Methods and results PCHF is a partnership between Inspira Health, National Health Service Cardiologists and Medtronic. The PCHF service uses retrospective clinical audit to identify patients requiring a prospective face-to-face consultation with a consultant cardiologist for clinical review of their HF management within primary care. The service is delivered via five phases: (i) system interrogation of general practitioner (GP) systems; (ii) clinical audit of medical records; (iii) patient invitation; (iv) consultant reviews; and (v) follow-up. A total of 78 GP practices (864 194 population) have participated. In total, 19 393 patients’ records were audited. HF register was 9668 (prevalence 1.1%) with 6162 patients coded with LVSD (prevalence 0.7%). HF case finder identified 9725 additional patients to be audited of whom 2916 patients required LVSD codes adding to the patient medical record (47% increase in LVSD). Prevalence of HF with LVSD increased from 0.7% to 1.05%. A total of 662 patients were invited for consultant cardiologist review at their local GP practice. The service found that within primary care, 27% of HF patients identified for a cardiologist consultation were eligible for complex device therapy, 45% required medicines optimization, and 47% of patients audited required diagnosis codes adding to their GP record. Conclusion A PCHF service can identify a missed cohort of patients with HF and LVSD, enabling the optimization of prognostic medication and an increase in device prescription.

中文翻译：

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初级保健心力衰竭服务确定了射血分数降低的心力衰竭患者的遗漏队列

目的 我们探讨了是否可以通过初级保健心力衰竭 (PCHF) 服务识别社区中遗漏的心力衰竭 (HF) 和左心室收缩功能障碍 (LVSD) 患者队列并接受治疗优化。方法和结果 PCHF 是 Inspira Health、国家卫生服务心脏病专家和美敦力之间的合作伙伴关系。PCHF 服务使用回顾性临床审核来识别需要与顾问心脏病专家进行前瞻性面对面咨询的患者，以对其初级保健中的 HF 管理进行临床审查。该服务通过五个阶段提供： (i) 全科医生 (GP) 系统的系统询问；(ii) 医疗记录的临床审核；(iii) 患者邀请；㈣ 顾问审查；(v) 后续行动。共有 78 家 GP 诊所（864 194 人）参与了该项目。总共审核了 19 393 名患者的记录。HF 登记为 9668（患病率 1.1%），其中 6162 名患者编码为 LVSD（患病率 0.7%）。HF 病例查找器确定了 9725 名需要审计的额外患者，其中 2916 名患者需要将 LVSD 代码添加到患者病历中（LVSD 增加 47%）。LVSD 的 HF 患病率从 0.7% 增加到 1.05%。共有 662 名患者被邀请在当地的 GP 诊所接受心脏病专家的顾问检查。该服务发现，在初级保健中，27% 的心脏病专家会诊的 HF 患者有资格接受复杂的设备治疗，45% 的患者需要优化药物，47% 的患者经过审核，需要将诊断代码添加到他们的 GP 记录中。