Observational studyClinical research in cardiology : official journal of the German Cardiac Society2014
Registry in Germany focusing on level-specific and evidence-based decision finding in the treatment of heart failure: REFLECT-HF.
Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
17 citing papers in PubMed, 32 citations in OpenAlex.
- Empagliflozin, irrespective of blood pressure, improves outcomes in heart failure with preserved ejection fraction: the EMPEROR-Preserved trial.European heart journal · 2023Trial
- A multicentre registry of hospitalized patients with acute and chronic heart failure: Study design of the HESC heart failure · 2025Observational
- Observational
- Guideline-led prescribing to ambulatory heart failure patients in a cardiology outpatient service.International journal of clinical pharmacy · 2021Article
- Burden of heart failure in Flemish general practices: a registry-based study in the Intego database.BMJ open · 2019Article
- Care pathways and treatment patterns for patients with heart failure in China: results from a cross-sectional survey.Drug design, development and therapy · 2018Article
- Treatment of chronic heart failure in Germany: a retrospective database study.Clinical research in cardiology : official journal of the German Cardiac Society · 2017Observational
- Heart failure and the holidays.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- General practitioners' adherence to chronic heart failure guidelines regarding medication: the GP-HF study.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Effects of spironolactone on ventricular-arterial coupling in patients with chronic systolic heart failure and mild symptoms.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- A real-world perspective on the prevalence and treatment of heart failure with a reduced ejection fraction but no specific or only mild symptoms.Heart failure reviews · 2015Review
- [Chronic heart failure : current guideline recommendations and innovations].Der Internist · 2015Review
- Gender aspects in clinical presentation and prognostication of chronic heart failure according to NT-proBNP and the Heart Failure Survival Score.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- Treatment of heart failure in real-world clinical practice: findings from the REFLECT-HF registry in patients with NYHA class II symptoms and a reduced ejection fraction.Clinical cardiology · 2015Observational
- Analyses of drugs stored at home by elderly patients with chronic heart failure.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- Substernal lead implantation: a novel option to manage DFT failure in S-ICD patients.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- ICD therapy for primary prevention of sudden cardiac death after Mustard repair for d-transposition of the great arteries.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Germany, care for patients with chronic heart failure (HF) is provided by hospital-based cardiologists (HBC), office-based cardiologists (OBC) and general practitioners (GP). We aimed to compare patient characteristics, diagnostic approaches and therapeutic decisions.
methodsMulti-centre, cross-sectional, observational survey at 48 physicians. Patients (n = 384) were required to have previously diagnosed HF and NYHA class ≥ II and/or a left ventricular ejection fraction of <50 %. A total of 384 patients were included at 5 HBCs, 26 OBCs and 18 GPs.
resultsA mean of 18.8 % of all patients at HBCs practices had heart failure, compared to a smaller proportion of 13.9 and 6.7 % at OBCs and GPs, respectively. Echo facility was available for all HBCs and OBCs, but for 16.7 % of GPs (p < 0.0001 for trend). Patients at HBCs had a higher NYHA class (65.6 % had class III/IV; p < 0.0001) compared to 36.8 % at OBCs and 39.3 % at GPs. Usage of three guideline-recommended pharmaceutical treatments was more than 80 %: diuretics (83.1 %), renin-angiotensin system blocking agents (91.4 %) and betablockers (90.1 %) with no differences between physician groups. Mineralocorticoid receptor antagonists (MRAs, overall 47.7 %) were more frequently prescribed by OBCs (54.7 %; p = 0.0007 for trend) than HBCs (43.8 %) and GPs (31.0 %). Ivabradin was not frequently used (11.0 % at OBCs, 4.9 % at HBCs and 0 % at GPs; p = 0.0163 for trend). The proportion of patients with CRT (8.6 %), ICD (23.5 %) and CABG (23.1 %) was not statistically different between groups.
conclusionREFLECT-HF demonstrates that there are some differences in evidence-based treatment decisions between the three main health services (HBC, OBC and GP) providing care for patients with HF in Germany. Advocating adherence to guideline recommendations and earlier adoption of these evidence-based treatments across all levels of care might further improve patient care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.