Key result
Poor physician adherence to heart failure guideline recommendations was associated with higher all-cause mortality compared with good adherence (HR 2.21; 95% CI 1.42-3.44; p=0.001).
Why the study?
Does good physician adherence to guideline-directed medical therapy improve 6-month mortality and hospitalization outcomes in heart failure patients?
Observational
Yes
Does good physician adherence to guideline-directed medical therapy improve 6-month mortality and hospitalization outcomes in heart failure patients?
Good physician adherence to guideline-directed medical therapy (prescribing at least 50% of recommended dosages) significantly reduces 6-month mortality and heart failure hospitalizations compared to poor adherence.
Supports targeting ≥50% GDMT doses in HF; extends real-world observational evidence on adherence benefits.
QUALIFY (QUality of Adherence to guideline recommendations for LIFe-saving treatment in heart failure surveY) showed that good physician adherence to guideline recommendations for angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta blockers, mineralocorticoid receptor antagonists and ivabradine, with prescription of at least 50 % of recommended dosages, was associated with better 6-month outcomes than moderate or poor adherence. Poor adherence was associated with higher all-cause mortality (hazard ratio 2.21; 95 % CI [1.42-3.44]; p=0.001) and combined heart failure hospitalisation or death (hazard ratio 1.26; 95 % CI [1.08-1.71]; p=0.024) compared with good adherence. Heart failure hospitalisation is a good opportunity to review a patient's medication and to optimise guideline adherence.
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Cowie et al. (2017) conducted an observational in Heart failure. Poor physician adherence to guideline recommendations vs. Good adherence was evaluated on All-cause mortality (HR 2.21, 95% CI 1.42-3.44, p=0.001). Poor physician adherence to heart failure guideline recommendations was associated with higher all-cause mortality compared with good adherence (HR 2.21; 95% CI 1.42-3.44; p=0.001).
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