Priority 20 from the Advanced Heart Failure PSP

UNCERTAINTY: Do health professionals understand the life / activity / functional consequences of each medicine? (JLA PSP Priority 20)
Overall ranking	20
JLA question ID	0098/20
Explanatory note	No significant evidence for people with advanced heart failure
Evidence	No systematic reviews on this topic in past five years
Health Research Classification System category	Cardiovascular

Extra information provided by this PSP
Original uncertainty examples	[My comments are around the huge consequences of one drug over another when both are in the same class. Specifically, how bisoprolol acted like a cosh whereas carvedilol was just pulled you down a little. There seemed to be little appreciation (or sympathy) for the difference in effect, and the life consequences. Being on Bisoprolol meant I couldn't walk 50 metres without sitting on a neighbour's wall with a heaving chest. Carvedilol meant I could cycle 5km to my cardiology appointment.] In sum the question is do clinicians really appreciate the life/activity/functional consequences of one medicine over another and the effects of titration of a given drug?
Submitted by	1 x patient

Extra information provided by this PSP

Original uncertainty examples

[My comments are around the huge consequences of one drug over another when both are in the same class. Specifically, how bisoprolol acted like a cosh whereas carvedilol was just pulled you down a little. There seemed to be little appreciation (or sympathy) for the difference in effect, and the life consequences. Being on Bisoprolol meant I couldn't walk 50 metres without sitting on a neighbour's wall with a heaving chest. Carvedilol meant I could cycle 5km to my cardiology appointment.] In sum the question is do clinicians really appreciate the life/activity/functional consequences of one medicine over another and the effects of titration of a given drug?

Submitted by

1 x patient

PSP information
PSP unique ID	0098
PSP name	Advanced Heart Failure
Total number of uncertainties identified by this PSP.	65 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	13 February 2019