Despite 91% awareness of GDMT for HFrEF, less than 6% of HCPs could implement it in over 90% of patients, highlighting critical gaps in knowledge and application.
Despite high perceived awareness of GDMT for HFrEF among Indian healthcare practitioners, actual knowledge of its components and implementation rates remain very low, highlighting the need for simplified decision-making tools.
Absolute Event Rate: 0% vs 0%
Abstract Background Guideline-directed medical therapy (GDMT) has been the cornerstone of recommendations that provide an overall framework for the management of heart failure. Diverse patient profiles and a lack of constant updates pose limitations to its implementation. An initiative called ‘Heart failure profiling wheel’(HFPW), a simple yet profound decision-making tool, could help address the unmet needs in implementing GDMT in the real-life practice setting. Purpose To substantiate the requirements for conceptualisation of the HF wheel, a pan-India survey was conducted to capture the perspectives of health care practitioners (HCPs) regarding the extent of their knowledge of GDMT and reported setbacks in its implementation. Methods A prospective, observational pre- and post-survey on knowledge and practical considerations in implementing GDMT was conducted in collaboration with the Indian College of Cardiology. The pre-survey questionnaire (before the development of HFPW) was circulated to HCPs practising across different regions of India using online platforms. The responses were collated, analysed, and represented as percentages. Results The survey was conducted among 2143 HCPs. About 91% of the respondents were aware of GDMT for HFrEF. The overall perception of knowledge in the study participants was poor, with 5% (n=105) correctly identifying all four components of GDMT (Figure 1A). Over half of the respondents considered nitrates and diuretics as part of GDMT. Nearly 31% and 16% responded that Ivabradine and calcium channel blockers, respectively as part of the GDMT (Figure 1C). Less than 6% responded that they were able to implement GDMT in over 90% of the patients. Among the participants, 64.67% implemented GDMT in 50% of HF patients and 35.33% implemented GDMT in 50% of HF patients. Among the classes of drugs, 42% prescribe ARNI and 46% prescribe SGLT2i in at least 50% of their patients with HFrEF (Figure 1B). Conclusion The pan-India survey highlights that despite the perceived awareness of GDMT among HCPs, there is a misperception of the knowledge on the components of GDMT. Only less than 6% responded that they were able to implement GDMT in over 90% of the patients. The study highlights the need for an action plan and a simplified approach to educate and enable adoption of strategies for successful implementation of GDMT. This supports and promotes the requirement of a simplified tool (such as the HFPW) that aligns to the contemporary management strategies to facilitate uniform and valid decision-making.Figure 1
Jayagopal et al. (Sat,) reported a other. Despite 91% awareness of GDMT for HFrEF, less than 6% of HCPs could implement it in over 90% of patients, highlighting critical gaps in knowledge and application.