Why the study?
Despite robust evidence, GDMT for HFrEF remains significantly underused in clinical practice due to therapeutic inertia, safety or tolerability concerns, and a lack of simplified, patient-profile-tailored treatment protocols.
This expert consensus provides tailored, patient-profile-based guidance to overcome therapeutic inertia and improve the implementation of GDMT for HFrEF in India.
Guides India-specific GDMT tailoring to reduce HFrEF inertia; reinforces consensus on early four-pillar benefits.
Heart failure with reduced ejection fraction (HFrEF) is a significant contributor to impaired quality of life, hospitalizations and mortality, globally as well as in India. Early and rapid initiation of the 4 pillars of guideline-directed medical therapy (GDMT) has been shown to significantly improve the morbidity and mortality rates associated with HFrEF. However, despite robust clinical evidence and proven benefits, GDMT is significantly underused in clinical practice. Lack of simplified, yet patient-profile-tailored treatment protocols, concerns regarding the safety or tolerability of medications, and therapeutic inertia commonly contribute to underuse. An Indian expert consensus was developed by using the modified Delphi technique to address the GDMT underuse. This expert consensus provides guidance on the use of GDMT based on the patient profiles encountered commonly in clinical practice with the objective of aiding optimal GDMT use and, thereby, improving the clinical outcomes in patients with HFrEF.
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Ponde et al. (2025) conducted a review in Heart failure with reduced ejection fraction (HFrEF). Guideline-directed medical therapy (GDMT) was evaluated. An Indian expert consensus developed using the modified Delphi technique provides guidance on patient-profile-tailored implementation of guideline-directed medical therapy for HFrEF.
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