ABSTRACT
Hypertension (HTN) is a major independent risk factor for the development of stroke, coronary artery disease (CAD), peripheral arterial disease (PAD), heart failure (HF) and chronic kidney disease (CKD). HTN is a growing public health problem in Oman, almost certainly the most prevalent modifiable risk factor for cardiovascular disease (CVD). The risk of CVD in patients with HTN can be greatly reduced with lifestyle modifications and effective antihypertensive therapy. Randomized trials have shown that blood pressure (BP) lowering produces rapid reductions in CV risk. Several studies have shown that the majority of the hypertensive patients remain uncontrolled. It is well established that the observed poor control of the disease is not only related to poor adherence to medications, but also to limited awareness and adherence to evidence-based management of hypertension among physicians. Several guidelines for the management of patients with hypertension have been published. However, the aim of this document is to provide the busy physicians in Oman with more concise and direct approach towards implementing these guidelines into clinical practice.
Subject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Cardiology/standards , Hypertension/drug therapy , Practice Patterns, Physicians'/standards , Blood Pressure Determination/standards , Humans , Hypertension/diagnosis , Hypertension/epidemiology , Hypertension/physiopathology , Oman/epidemiology , Predictive Value of Tests , Risk Factors , Risk Reduction Behavior , Treatment OutcomeABSTRACT
Although atrial fibrillation (AF) is the most common cardiac arrhythmia, there is variation in practice with regard to the management of acute AF among the hospitals and even within the same hospital in Oman. This variation likely reflects a lack of high-quality evidence. Standard guidelines and textbooks do not offer clear evidence-based direction for physicians to guide the management of acute AF. Particularly controversial is the issue of using rhythm control or rate control. This stimulated Oman Heart Association (OHA) to issue a simplified protocol for the management of acute AF to be applied by the entire cardiac caregivers all over the country. The priorities for acute management of AF include stabilizing the patient's hemodynamic status, symptom control, treatment of the underlying and precipitating cause, and more importantly protecting the brain.
Subject(s)
Anti-Arrhythmia Agents/administration & dosage , Anticoagulants/administration & dosage , Atrial Fibrillation , Electric Countershock/methods , Acute Disease , Adult , Aged , Atrial Fibrillation/diagnosis , Atrial Fibrillation/physiopathology , Atrial Fibrillation/therapy , Disease Management , Electrocardiography , Evidence-Based Practice , Female , Heart Rate , Humans , Male , Middle Aged , OmanABSTRACT
In 2012, Oman Heart Association (OHA) published its own guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction, the aim was not to be comprehensive but rather simplified and practical in order to reduce the gap between the long comprehensive guidelines and our actual practice. However, we still feel that the busy registrars and residents need simpler and direct clinical pathways or protocol to be used in the emergency departments, coronary care units and in the wards. Clinical pathways are now one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes in acute care.
ABSTRACT
Although current practice guidelines provide an evidence-based approach to the management of acute coronary syndromes, application of the evidence by individual physicians has been suboptimal. This gap between comprehensive guidelines and actual practice stimulated Oman Heart Association to issue a simplified series for the management of the common cardiac abnormalities to be applied by the entire cardiac caregivers all over the country. This simplified approach for the management of non-ST-elevation acute coronary syndrome provides a practical and systematic means to implement evidence-based medicine into clinical practice.
