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Lack of specialist services prevents good GP beta blocker care

GPs are struggling to deliver appropriate beta-blocker treatment to everyone who needs it, partly because of lack of access to good-quality specialist services, researchers warn.

An audit of 152 general practices showed that in 2005, only 30% of men and 20% of women with heart failure were prescribed bisoprolol, carvedilol, metoprolol, and nebivolol.

A further 12% of men and women in the study of more than 7,000 patients were prescribed beta-blockers not recommended by guidelines, such as atenolol.

The researchers said there was scope for an additional 45% of patients with heart failure to be prescribed [beta]-blockers - 155,000 extra across the UK – with the potential to prevent 7,800 deaths and 9,750 hospital admissions every year.

But the study, in the December issue of the British Journal of General Practice, did find there had been improvement in prescribing since 2000, when only 6% of men and 4% of women with heart failure were on [beta]-blockers.

Study leader, Dr Sunil Shah, senior lecturer in the Department of Community Health Sciences from St Georges University Medical School in London said fear of side-effects was one of the barriers to widespread use of the drugs.

‘The main message is that there is still significant potential for improving care for patients with heart failure through increased appropriate use of [beta]-blockers. GPs should not be solely responsible for delivering this improvement as PCTs, hospitals and specialist services have an important part to play.'

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