Beta Blockers Use in Cardiac Failure: Does the Current Prescribing Practice at a Large Urban Hospital in Zimbabwe Exhibit Evidence Based Care and Offer Optimal Therapy for Cardiac Failure Patients?

Abstract

Background: Cardiac failure treatment largely focused on symptomatic relief at the expense of the address of the underlying disease process of cardiac remodelling. This old wisdom of practice has been turned around by clinical research findings that have shown that there are agents that reverse cardiac remodelling and offer long-term benefits to cardiac failure patients. This has led to the recommendation of evidence-based practice in chronic heart failure management using reverse modelling agents such as beta blockers. Objectives: To ascertain the prescribing patterns of beta blockers in cardiac failure patients by doctors in a public hospital setting and determine the prevalence of cardiac failure hospitalisation and the age groups involved. Study design: A retrospective medical records review observational study. Methodology: A sample size of 385 cardiac failure cases was used. Data on cardiac failure patients who were once hospitalised at the hospital of study were abstracted from the patients’ medical records files using data collection forms. Results: There were 36 (9.4%) patients who were prescribed beta blockers, 7 patients had their beta blocker substituted for another. Atenolol was prescribed to 30 (7.8%) patients, propranolol to 7 (1.8%) and carvedilol to 6 (1.6%) patients. Metoprolol and bisoprolol were not prescribed at all. There were more females (57.9%) than males (42.1%) and the mean age was 41.9 (standard deviation 24.0) years. The prevalence of cardiac failure hospitalisation was 1.54%. Conclusion: The rate of beta blocker prescribing was low. There is need for emphasis on evidence-based treatment options in the management of cardiac failure in Zimbabwe.