Healthcare utilization and guideline-directed medical therapy in heart failure patients with reduced ejection fraction

Abstract

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.

Factors Influencing Thirty-Day Readmission Rate in Patients With Heart Failure Exacerbation

“…In addition, a diuretic may be added as needed for the patient's symptom and class. Despite significant evidence of GDMT, a majority of HF patients do not receive the complete therapy [4]. This poor implementation has been attributed to a number of factors such as the lack of understanding of treatment goals, a hesitancy to use newly recommended drugs, a focus on symptom relief rather than mortality reduction, or a fear of adverse effects.…”