Novel Initiative Increasing GDMT Use Among Patients With Heart Failure With Reduced Ejection Fraction.
JACC Heart Fail
; 12(8): 1487-1493, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38934962
ABSTRACT
Guideline-directed medical therapy utilization in patients with heart failure with reduced ejection fraction (HFrEF) remains low despite benefits in morbidity and mortality. The authors describe a unique quality improvement initiative designed to increase angiotensin receptor-neprilysin inhibitor (ARNI) and mineralocorticoid receptor antagonist (MRA) utilization in outpatients with HFrEF in a large cardiology practice, whereby eligible patients were identified in a standardized review process and medication utilization rates were linked to group quality metrics. Eligible HFrEF patients were defined as having a left ventricular ejection fraction (LVEF) ≤40% and NYHA functional class II to IV level of symptoms. Those with an LVEF >40%, no documented LVEF, or with NYHA functional class I symptoms were excluded. ARNI utilization was defined as any dose of sacubitril/valsartan prescribed, and MRA utilization was defined as any dose of either spironolactone or eplerenone prescribed. Group quality metric targets were set at >25% ARNI prescription and >60% MRA prescription in eligible patients. Following project implementation, ARNI utilization rose from 31% to 67% and MRA increased from 28% to 66%. Establishing clear quality metrics and formulating a proactive evaluation process was associated with a significant increase in prescription rates.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Volume Sistólico
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Compostos de Bifenilo
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Neprilisina
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Antagonistas de Receptores de Mineralocorticoides
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Antagonistas de Receptores de Angiotensina
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Valsartana
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Aminobutiratos
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Insuficiência Cardíaca
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article