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Posted By: Daniel Thibodeau, MHP, PA-C
June 14, 2019
Many of us manage patients with heart failure with a reduced ejection fraction, or HFrEF. The management of this patient population is complex, and most patients usually have more active problems than just heart failure. That is why it is not a surprise that a recent study showed that we as practitioners are not doing as well as we could when it comes to following the appropriate guidelines for heart failure.
According to the CHAMP-HF registry, many patients are not being prescribed the appropriate medications that are recommended within the guidelines published by the American Heart Association (AHA) and American College of Cardiology (ACC). The medications that were studied to determine their use and compliance with the guidelines were angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB), beta blockers, angiotensin receptor/neprilysin inhibitors (ARNI), and mineralocorticoid receptor antagonists. The study showed a large percentage of eligible patients were either not placed on the appropriate medication, not given the target dose, or not prescribed medication at all. While ACE inhibitors and beta blockers were better than the other classes of medications, the data showed that there were significant gaps in coverage for medications that would benefit patients with heart failure. The conclusions were simple: patients who qualify for these medications should be placed on them when appropriate, and practitioners are encouraged to follow the AHA/ACC guidelines.
We all want our patients to succeed. However, following the recommended guidelines must be done in order to achieve the best possible outcomes for this complicated disease. We owe it to our patients to do better!
- Greene SJ, Butler J, Albert NM, et al. Medical therapy for heart failure with reduced ejection fraction: the CHAMP-HF registry. J Am Coll Cardiol. 2018;72:351-366.