A Retrospective Cohort Study of Heart Failure in the Australian Primary Care Setting – Method and Demographic Results (SHAPE study)

This study sought to describe the ‘real world’ state of heart failure (HF) and its management in Australian primary care. Analyses were undertaken of secondary de-identified data of adult patients seen between 1 July 2013 and 30 June 2018 from a large network of general practices across Australia. We examined structured data from medical records (e.g. diagnoses, medications) as well as free text entries in the consultation notes for pre-specified, HF-relevant terms to identify and describe the HF population. Data were examined for the presence of a diagnosis of HF, use of HF-specific medications, HF-diagnostic investigation (e.g. BNP/NT-proBNP, echocardiography) results and typical signs/symptoms of HF. The population was then stratified into three groups based on a hierarchy of diagnostic criteria: (1) definite HF, (2) probable HF and (3) possible HF. The practices provided care to 1.93 million individual adult patients. From this population, 16,990 (0.88%) were in group (1), 4888 (0.25%) in (2) and 36,446 (1.89%) in (3). Of the 1.13% of the population with either definite or probable HF, the median age was 72 years (IQR 59–83); 50.6% were female and 1.65% were classified as Aboriginal/Torres Strait Islander. A recorded HF diagnosis (11,937) and HF-specific medications (4773) were the most common methods to classify “definite HF” patients. Typical signs and symptoms of HF in combination with diuretic use was the most common method to classify “probable HF” patients (4756). This novel approach is the largest Australian real-world evidence study of HF, quantifying the characteristics of this population.