Physicians' Guideline Adherence is Associated with Long-Term Heart Failure Mortality in Outpatients with Heart Failure with Reduced Ejection Fraction: The Qualify International Registry
Why the study?
Although physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in HFrEF, its impact on longer-term outcomes is poorly documented.
Does physicians' adherence to guideline-recommended HF therapies improve long-term outcomes in ambulatory HFrEF patients?
Population
6118 ambulatory HFrEF patients
Comparison
Physician guideline adherence level for five classes of recommended HF medications and dosages
Design
International prospective observational survey
Follow-up
18 months
Authors
Discussion
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Member takes
Implication
Guideline adherence may link to better 18-month HFrEF outcomes; hypothesis-generating for adherence interventions before changing practice.
Structured PICO
Does physicians' adherence to guideline-recommended HF therapies improve long-term outcomes in ambulatory HFrEF patients?
P
Population
6,118 ambulatory patients with heart failure with reduced ejection fraction (HFrEF) from the QUALIFY international prospective observational survey
I
Intervention
Higher physicians' adherence to guideline-recommended HF therapies (measured as a continuous variable from 0 to 1 for five classes of recommended HF medications and dosages)
C
Comparator
Lower physicians' adherence to guideline-recommended HF therapies
O
Outcome
Heart failure death, composite of HF hospitalization or CV death, and unplanned all-cause, CV, or HF hospitalizations at 18 monthscomposite
Higher physician adherence to guideline-recommended HF therapies is significantly associated with reduced HF mortality and a lower composite risk of HF hospitalization or CV death at 18 months in ambulatory HFrEF patients.
Cite This Study
Komajda et al. (2019) studied this question.