The Guidelines and Protocols Advisory Committee’s (GPAC) guideline for improved diagnosis and management of adults with chronic heart failure (HF) in the primary care setting is available to physicians across BC at www.BCGuidelines.ca.
• B-type natriuretic peptide (BNP) or N-terminal prohormone of BNP (NT-proBNP) is the biochemical test of choice for ruling-in or ruling-out the diagnosis of HF and should be considered as part of the initial evaluation of patients with dyspnea suspected of having HF.
• BNP (or NT-proBNP) testing should not be used routinely for monitoring disease severity.
• Educate the patient and family about the importance of self-monitoring to identify early decompensation at a stage where intervention may help to avoid hospitalization. Consider referral to a heart function clinic or a multidisciplinary chronic disease management clinic.
• Identify who would benefit from a palliative care assessment by using the iPall Heart Failure: Palliative Care Assessment Tool (www.bcheartfailure.ca/for-bc-healthcare-providers/end-of-life-tools/). Initiate advance care planning discussions early in the disease course.
• The goals of pharmacologic management for HF patients with preserved ejection fraction (HF-pEF) are to control heart rate, blood pressure, and volume status, as no medications have shown a mortality benefit in this patient group.
• For patients with reduced ejection fraction (HF-rEF) there is robust mortality data to support the use of pharmacological and device therapies. These treatments have also been shown to improve symptom status and quality of life, and to decrease the risk of HF-related hospitalization.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org