Abstract | March 24, 2024

Adoption of Guideline-Directed Medical Therapy in Heart Failure with Reduced Ejection Fraction: An Analytical Series from a Singular Institutional Viewpoint.

Sophia Navajas, MD, Interal Medicine,PGY2, Broward Health North, Deerfield Beach, FL

Melisa Hidalgo, MD, Interal Medicine,PGY3, Broward Health North, Deerfield Beach, FL; Kevin Cortes, MD, Interal Medicine,PGY3, Broward Health North, Deerfield Beach, FL; Jordy Godinez MD, Hospitalist, Internal Medicine, Broward Health North, Deerfield Beach, FL and Reyna Yordanka, MD, Medical Director, Heart Failure, Broward Health Medical Center, Fort Lauderdale, FL

Learning Objectives

  1. To improve adoption rates of guideline directed medical therapy in patients with HFrEF
  2. To reduce readmission rate of these patient population
  3. To identify and educate about socioeconomic barriers in healthcare

Background: Congestive heart failure (CHF) afflicts roughly six million U.S. citizens, forecasted to generate an economic burden of $70 billion by 2030(1). CHF has been identified by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) as a primary area of concern for those aged 65 and older (2). Guideline-Directed Medical Therapy (GDMT) employs pharmacological treatments like ARNI, SGLT2 inhibitors, MRA, and Beta-Blockers, proven to enhance patients’ functional status while diminishing readmissions and mortality (3-8). Notwithstanding its substantiated efficacy, its integration into routine medical practice is suboptimal (8-14).

Purpose: This investigation elucidates GDMT’s suboptimal utilization, simultaneously recognizing the potential barriers in prescribing select treatments in non-profit settings.

Goals: Improve adoption rate of GDMT, reduce patient readmission, identify, and educate about viable strategies to overcome existing socioeconomic healthcare barriers.

Methods/Design: A retrospective examination undertaken at Broward Health North encompassing 105 patient samples, supplemented by an in-depth review of four prominent registry studies.
Results/Findings: Rigorous evaluation, compensating for prior therapy inefficacies or contraindications, discerned that 30% of patients were viable ARNI candidates, 57% for SGLT2 inhibitors, 57.14% for MRA, and 18.09% for beta-blockers. Despite this, such treatments remained unadministered. These findings outperformed previous registry study results.

Conclusions/Implication: There exists an urgent need to devise and implement strategies that bolster the guideline-directed administration of HFrEF medications.

References and Resources

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