Key result
Physician adherence to HFrEF GDMT reaches ~40%, limited primarily by suboptimal beta-blocker dosing.
Why the study?
Adhering to GDMT improves treatment outcomes in HFrEF, but studies evaluating the status of GDMT adherence among patients with HF in Ethiopia are scarce.
Observational
No
In a specialized hospital in Ethiopia, adherence to GDMT for HFrEF was suboptimal, with only 40% of patients receiving good adherence and most receiving suboptimal doses, particularly of beta-blockers.
Background: Adhering well to guideline-directed medical therapy (GDMT) is essential for improving treatment outcomes in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Despite its significance, studies on the status of GDMT adherence in patients with HF in Ethiopia are scarce. Objective: This study aimed to assess physicians' adherence to GDMT and the associated factors in patients with HFrEF. Methods: A retrospective follow-up study was conducted from September 1, 2018, to July 31, 2023. Quality of Adherence to Guideline Recommendations for Lifesaving Treatment in Heart Failure Survey scores were used to assess physicians' adherence to GDMT. SPSS version 27.0 was used for analysis, and multinomial logistic regression analysis was performed. Results: The Quality of Adherence to Guideline Recommendations for Lifesaving Treatment in Heart Failure Survey scores showed that the physicians' adherence to GDMT was good in 40% (95% confidence interval [CI] 35.30-44.90), moderate in 33.8% (95% CI 29.3-38.6), and poor in 26.2% of the study participants (95% CI 22-30.7). Age of ≥65 years (adjusted odds ratio [AOR] 0.14, 95% CI 0.07-0.29); causes of HF such as ischemic heart disease (AOR 16, 95% CI 6.75-37.90), valvular heart disease (AOR 5.3, 95% CI 2.58-10.92), dilated cardiomyopathy (AOR 8.24, 95% CI 3.97-17.09), and hypertension (AOR 6.62, 95% CI 2.98-14.69); and duration of HFrEF of ≥3 years (AOR 2.59, 95% CI 1.32-5.08) were factors significantly associated with good physicians' adherence to GDMT. Conclusion: The use of all indicated medications as per the guideline recommendation for HFrEF was low, and most patients received suboptimal doses of GDMT. Particularly, the beta-blocker dose was very suboptimal. Encouraging healthcare provider training, access to separate cardiac clinics and cardiologists, following guidelines, timely patient appointments, and medication availability are recommended for better clinical outcomes.
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Anberbr et al. (2025) conducted an observational in Heart failure with reduced ejection fraction (HFrEF). Guideline-directed medical therapy (GDMT) was evaluated on Good adherence to guideline-directed medical therapy (95% CI 35.30-44.90). Physicians' adherence to guideline-directed medical therapy for HFrEF was good in 40% of cases (95% CI 35.30-44.90), with most patients receiving suboptimal doses, particularly of beta-blockers.
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