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    Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study.

    Access Status
    Fulltext not available
    Authors
    Driscoll, Andrea
    Dinh, Diem
    Wong, James
    Hopper, Ingrid
    Mariani, Justin
    Zimmet, Hendrik
    Brennan, Angela
    Lefkovits, Jeffery
    Carruthers, Harriet
    Reid, Christopher
    Date
    2020
    Type
    Journal Article
    
    Metadata
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    Citation
    Driscoll, A. and Dinh, D. and Wong, J. and Hopper, I. and Mariani, J. and Zimmet, H. and Brennan, A. et al. 2020. Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. Heart, Lung and Circulation.
    Source Title
    Heart, Lung and Circulation
    DOI
    10.1016/j.hlc.2020.04.012
    ISSN
    1443-9506
    Faculty
    Faculty of Health Sciences
    School
    School of Public Health
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/1136372
    http://purl.org/au-research/grants/nhmrc/1113314
    URI
    http://hdl.handle.net/20.500.11937/80044
    Collection
    • Curtin Research Publications
    Abstract

    BACKGROUND: Multiple co-morbidities complicate initiation of medical therapy in patients with heart failure with reduced ejection fraction (HFrEF). Adherence to guidelines based on individual patient profiles is not well described. This paper examines the effect of individual patient profiles on guideline recommended therapies for HFrEF.

    METHODS: This was a prospective, observational, non-randomised study of hospitalised HFrEF patients over 30 days, from 2014 to 2017 in 16 hospitals. A previously developed algorithm-based guideline adherence score was used to determine adherence to key performance indicators: prescribing of beta blockers, angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), mineralocorticoid-receptor antagonist (MRAs) for HFrEF patients and early outpatient and heart failure (HF) disease management program review. Patients were classified as low, moderate and excellent adherence to medical therapy. RESULTS: Of the 696 HFrEF patients, 69.1% (n=481) were male with an average age of 73.15 years (SD±14.5 years). At discharge, 64.6% (n=427) were prescribed an ACEI/ARB, 78.7% (n=525) a beta blocker and 45.3% (n=302) prescribed MRA. Based on individual patient profiles, 18.2% (n=107) of eligible patients received an outpatient clinic and HF disease management program review within 30 days and 41.5% (n=71) were prescribed triple therapy. Based on individual profiles, 13% (n=21) of patients received an excellent guideline adherence score.

    CONCLUSION: Individual patient profiles impact on adherence to guideline recommendations. Review in transitional care and prescribing of triple pharmacotherapy is suboptimal. Translational strategies to facilitate the implementation of guideline recommended therapies is warranted.

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