Robyn, S.Eckert, K.Stewart, S.Phillips, S.Yallop, J.Tonkin, A.Krum, H.2011-12-142011-12-142007Medical Journal of Australia, 2007; 186(9):441-4450025-729X1326-5377http://hdl.handle.net/2440/68844Objective: To determine whether primary care management of chronic heart failure (CHF) differed between rural and urban areas in Australia. Design: A cross-sectional survey stratified by Rural, Remote and Metropolitan Areas (RRMA) classification. The primary source of data was the Cardiac Awareness Survey and Evaluation (CASE) study. Setting: Secondary analysis of data obtained from 341 Australian general practitioners and 23 845 adults aged 60 years or more in 1998. Main outcome measures: CHF determined by criteria recommended by the World Health Organization, diagnostic practices, use of pharmacotherapy, and CHF-related hospital admissions in the 12 months before the study. Results: There was a significantly higher prevalence of CHF among general practice patients in large and small rural towns (16.1%) compared with capital city and metropolitan areas (12.4%) (P < 0.001). Echocardiography was used less often for diagnosis in rural towns compared with metropolitan areas (52.0% v 67.3%, P < 0.001). Rates of specialist referral were also significantly lower in rural towns than in metropolitan areas (59.1% v 69.6%, P < 0.001), as were prescribing rates of angiotensin-converting enzyme inhibitors (51.4% v 60.1%, P < 0.001). There was no geographical variation in prescribing rates of β-blockers (12.6% [rural] v 11.8% [metropolitan], P = 0.32). Overall, few survey participants received recommended “evidence-based practice” diagnosis and management for CHF (metropolitan, 4.6%; rural, 3.9%; and remote areas, 3.7%). Conclusions: This study found a higher prevalence of CHF, and significantly lower use of recommended diagnostic methods and pharmacological treatment among patients in rural areas.en©The Medical Journal of Australia 2007HumansAngiotensin-Converting Enzyme InhibitorsEchocardiographyHospitalizationHealth Care SurveysCross-Sectional StudiesEvidence-Based MedicineRural PopulationUrban PopulationRural Health ServicesUrban Health ServicesDrug UtilizationReferral and ConsultationPrimary Health CareAustraliaHeart FailurePractice Patterns, Physicians'Journal article002010869910.5694/j.1326-5377.2007.tb00993.x0002465822000042-s2.0-3424928768829714Stewart, S. [0000-0001-9032-8998]