Key result
Patients with HFrEF not on guideline-directed medical therapy had 29% higher annual all-cause hospitalizations (80 vs 62 per 100 patients) compared to those on GDMT.
Why the study?
The effect of guideline-directed medical therapy on healthcare utilization in patients with heart failure with reduced ejection fraction was not well characterized.
Does guideline-directed medical therapy reduce healthcare utilization in patients with heart failure with reduced ejection fraction?
Cohort
Does guideline-directed medical therapy reduce healthcare utilization in patients with heart failure with reduced ejection fraction?
Absolute Event Rate: 62% vs 80%
p-value: p=<0.0001
In a real-world HFrEF population, lack of optimal guideline-directed medical therapy is associated with significantly higher healthcare utilization, including hospitalizations and emergency department visits.
Supports GDMT optimization to lower HFrEF utilization; reinforces guidelines with real-world evidence.
Aim: This study examines the effect of guideline-directed medical therapy (GDMT) on healthcare utilization in patients with heart failure with reduced ejection fraction from Optum ® Integrated File from 1 January 2007 to 30 June 2020. Materials & methods: Patients with both a beta blocker and either an ACE inhibitor (ACE-I), angiotensin receptor blocker (ARB) or angiotensin receptor neprilysin inhibitor were assigned to the GDMT cohort. All others were not on GDMT. Results: Estimated annual all cause hospitalizations and emergency department visits per 100 patients was 29% (80 vs 62 patients) and 26% higher (54 vs 43 patients; p < 0.0001) and annualized hospital days were longer (1.88 vs 1.64; p = 0.0020) for patients not on GDMT. Conclusion: In a real-world population, heart failure with reduced ejection fraction, patients not optimally managed on GDMT had higher annualized healthcare utilization when compared with patients on GDMT.
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McCullough et al. (2021) conducted a cohort in Heart failure with reduced ejection fraction. Guideline-directed medical therapy (GDMT) vs. Not on GDMT was evaluated on Annual all-cause hospitalizations per 100 patients (p=<0.0001). Patients with HFrEF not on guideline-directed medical therapy had 29% higher annual all-cause hospitalizations (80 vs 62 per 100 patients) compared to those on GDMT.
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