What question did this study set out to answer?

Evaluate the outpatient prescription rates of guideline-directed medical therapy among individuals with heart failure with reduced ejection fraction in India.

February 16, 2016Clinical CardiologyOpen Access

Guideline‐Directed Medication Use in Patients With Heart Failure With Reduced Ejection Fraction in India: American College of Cardiology's PINNACLE India Quality Improvement Program

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Population

15,870 outpatients with HFrEF seeking care in 10 centers enrolled in the PIQIP registry in India, mean age…

Design

Cohort

Authors

YPYashashwi PokharelAtrium Health Wake Forest Baptist JWJessica WeiAmerican College of Cardiology RHRavi S. HiraMultiCare Health System

Discussion

Member takes

Implication

Highlights GDMT gaps in Indian HFrEF; leaves open targeted implementation research.

Key Points

Evaluate the outpatient prescription rates of guideline-directed medical therapy among individuals with heart failure with reduced ejection fraction in India.
Analyzed outpatient records from 10 medical centers enrolled in the PINNACLE India Quality Improvement Program (PIQIP) registry between January 2008 and September 2014.
Identified N=15,870 patients with documented left ventricular ejection fraction ≤40% out of 75,639 total patients in the registry.
Documentation of ACE inhibitors or ARBs occurred in 33.5% of patients, beta-blockers in 34.9%, and both drug classes combined in only 29.6%.
Prescription of guideline-directed medical therapy was significantly higher in men, patients aged ≥65 years, and individuals with hypertension, diabetes, or coronary artery disease.
Approximately two-thirds of outpatients with ejection fraction ≤40% lacked documented guideline-directed medical therapy, despite gradual improvements over the study period.

Structured PICO

Population

15,870 outpatients with HFrEF (EF ≤40%) seeking care in 10 centers enrolled in the PIQIP registry in India, mean age 56 years, 23% female.

Outcome

Documentation of use of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and β-blockers

In a large Indian registry, there is significant underutilization of guideline-directed medical therapy for HFrEF, with only about one-third of patients receiving ACEI/ARB or beta-blockers.

Cite This Study

Pokharel et al. (2016) studied this question.

synapsesocial.com/papers/6a89567481d3bfa98ef7c4d9 https://doi.org/10.1002/clc.22519

Topics

HFrEF treatment Heart failure HFpEF management

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Guideline‐Directed Medication Use in Patients With Heart Failure With Reduced Ejection Fraction in India: American College of Cardiology's PINNACLE India Quality Improvement Program

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Guideline‐Directed Medication Use in Patients With Heart Failure With Reduced Ejection Fraction in India: American College of Cardiology's PINNACLE India Quality Improvement Program

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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