Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study.
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 gui...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2020
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/80044 |
| _version_ | 1848764147559301120 |
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| author | Driscoll, Andrea Dinh, Diem Wong, James Hopper, Ingrid Mariani, Justin Zimmet, Hendrik Brennan, Angela Lefkovits, Jeffery Carruthers, Harriet Reid, Christopher |
| author_facet | Driscoll, Andrea Dinh, Diem Wong, James Hopper, Ingrid Mariani, Justin Zimmet, Hendrik Brennan, Angela Lefkovits, Jeffery Carruthers, Harriet Reid, Christopher |
| author_sort | Driscoll, Andrea |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:14:44Z |
| format | Journal Article |
| id | curtin-20.500.11937-80044 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:14:44Z |
| publishDate | 2020 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-800442020-08-12T06:49:03Z Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. Driscoll, Andrea Dinh, Diem Wong, James Hopper, Ingrid Mariani, Justin Zimmet, Hendrik Brennan, Angela Lefkovits, Jeffery Carruthers, Harriet Reid, Christopher Clinical guideline adherence Early review Heart failure Medication adherence 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. 2020 Journal Article http://hdl.handle.net/20.500.11937/80044 10.1016/j.hlc.2020.04.012 eng http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1113314 restricted |
| spellingShingle | Clinical guideline adherence Early review Heart failure Medication adherence Driscoll, Andrea Dinh, Diem Wong, James Hopper, Ingrid Mariani, Justin Zimmet, Hendrik Brennan, Angela Lefkovits, Jeffery Carruthers, Harriet Reid, Christopher Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. |
| title | Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. |
| title_full | Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. |
| title_fullStr | Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. |
| title_full_unstemmed | Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. |
| title_short | Impact of Individual Patient Profiles on Adherence to Guideline Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction: VCOR-HF Study. |
| title_sort | impact of individual patient profiles on adherence to guideline directed medical therapy in heart failure with reduced ejection fraction: vcor-hf study. |
| topic | Clinical guideline adherence Early review Heart failure Medication adherence |
| url | http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/80044 |