Heart failure: Study finds black patients are less likely to get the devices and implants they need




CNN

There is increasing evidence that black heart failure patients are less likely to receive advanced treatments than white patients.

A study published Wednesday in the journal Circulation: heart failure He found that among a group of adults with heart failure, white people were twice as likely as black people to receive a heart transplant or a ventricular assist device, a mechanical heart pump often used for patients with end-stage heart failure.

“The entirety of the evidence suggests that we as providers of heart failure perpetuate existing inequalities,” says Dr. Thomas Cassino, first author of the study and clinical instructor in the Department of Cardiovascular Diseases at the University of Michigan in Ann Arbor. He said in a press release. However, recognizing the differences is not enough. As clinicians and healthcare providers, we must find ways to bring about just change.”

Researchers analyzed data from 377 adults being treated for heart failure in the United States, of whom 27% were identified as black, between July 2015 and June 2016.

The data showed that a heart transplant or a ventricular assist device was performed in 11% of black patients compared to 22% of white patients, although death rates were similar in both: 18% in black patients and 13% in white patients.

The researchers noted that patients’ preferences for VADs, heart transplants, or other treatments did not affect the results.

This residual unfairness may be the result of structural racism, discrimination, or provider bias influencing the decision-making process, the researchers wrote.

Experts in the field say the findings provide confirmation of what doctors have been seeing for years.

“I can’t say I’m surprised,” said Dr. Jaime Trivedi, assistant professor at the University of Louisville School of Medicine. Who studies the racial differences between heart patients?. He was not involved in the new research.

Trivedi’s recommendation for cardiovascular care is that you participate in your health journey. Your family or loved ones should also be closely involved.

The new findings also came as no surprise to Dr. Dave Montgomery, MD, a cardiologist at Piedmont Healthcare in Atlanta.

“The study confirms what has been known for a long time, which is that black heart failure patients have worse outcomes, and that part of the reason for the worse outcomes is the gradation in the quality of care provided to them,” Montgomery said. He was also not involved in the new research.

“Although I am not surprised to see the results of this study, I am encouraged by the new information provided by this study. These data refute the idea that varying heart failure outcomes have to do with things like patient personal preferences,” he said. The problem is not vague and inaccessible, as we used to think in the past. Instead, it shows outstanding progress toward better care for all.”

Dr. Bessie Young, associate professor of health systems and population health at the University of Washington, said people should be educated about how to advocate for themselves and seek options, such as a VAD, that they may not know about.

“There’s only a difficulty for certain groups of people to get some of these really life-saving procedures and implants, and there has to be some kind of systemic change that’s been made about who are the custodians of these devices and how people think about how patients get these,” Young said.

Young, a health equity researcher who was not involved in the study, believes it shows that the disparity is caused by social determinants such as education and access, rather than biological determinants.

Regarding the study’s implications for health care providers, she said, “There has to be fairness among the people who get these resources, because they are very limited. And here’s where you have to make sure that people look at how they rate people to get a device or an implant, with Making sure they use some kind of fairness lens to do that.”


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