RT Journal Article
SR Electronic
T1 28 The use of subcutaneous furosemide for the symptomatic management of patients with end stage heart failure in the community; a GP survey
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP A19
OP A19
DO 10.1136/bmjspcare-2019-ASP.51
VO 9
IS Suppl 1
A1 Lundy, Emma
YR 2019
UL http://spcare.bmj.com/content/9/Suppl_1/A19.2.abstract
AB Heart failure (HF) is appropriately described as an epidemic with recent estimates suggesting there are more than half a million people living with this syndrome in the UK alone.For patients with end-stage HF (ESHF), diuretic therapy is the cornerstone of treatment. These patients frequently require escalation to parenteral diuretics for symptom management; this can be a challenging option for patients who wish to be cared for at home. Continuous subcutaneous infusion (CSCI) of medication via a syringe driver (SD) has been used for over 30 years, revolutionising the care of dying people. Administering furosemide via this route can be an effective alternative to intravenous (IV) therapy.An electronic survey was sent to General Practitioners (GPs) across the five Health and Social Care Trusts in Northern Ireland (NI) to determine if subcutaneous furosemide was being prescribed for patients in the community with ESHF. The survey was disseminated via email and private social media sites.63 GPs completed the survey. 86% of GPs did not know that furosemide could be given subcutaneously with only 5% of GPs having ever prescribed it. 90% of GPs felt that there was a role for subcutaneous furosemide and under specialist guidance 86% of GPs would be willing to prescribe it. 44% of GPs felt that they would need additional training to feel confident in prescribing subcutaneous furosemide and expressed concerns, such as, availability of medication, training for district nurses, additional GP workload, anxiety relating to blood monitoring and choosing the appropriate dose.Subcutaneous furosemide can be beneficial in the symptomatic management of patients with ESHF. With specialist guidance, training and support GPs in NI would be willing to consider this as a treatment option, which could prevent unnecessary hospital admissions and allow patients with ESHF to die comfortably in their own home.