Abstract
Background
Guideline-directed medical therapy (GDMT) reduces mortality and hospitalizations in
adults with heart failure with reduced ejection fraction (HFrEF); however, few are
receiving GDMT. National registries show as few as 1% of patients are receiving appropriate
GDMT. Development of heart failure clinics achieving optimal GDMT are crucial to improve
outcomes for HFrEF patients.
Objective
We developed a multidisciplinary HF-Optimize clinic aimed at improving GDMT use along
with providing education, resources, and comorbidity screening for adults with HFrEF.
Methods
We targeted patients with newly diagnosed HFrEF and/or recent or multiple admissions
for 6 visits over 12 weeks. We measured medication use, ejection fraction, 6-minute
walk test distance, and health-related quality of life (EuroQol Visual Analog Scale)
at visits 1 and 6.
Results
One-hundred ten patients completed all visits. Patients were a mean age of 58 (±14)
years, 37% were female, and 42% were of non-White race. From visit 1 to visit 6, utilization
of GDMT increased from 35.5% to 85.5% (p < 0.001) and significant improvements in ejection fraction (25.9% to 35.5%, p < 0.001), 6-minute walk distance (1032 feet to 1121.7 feet, p = 0.001), and quality of life (63.8/100 vs 70.8/100, p = 0.002). Only 2 patients (1.8%) that completed HF-Optimize had a 30-day heart failure
readmission.
Conclusion
Our multidisciplinary HF-Optimize clinic improved medication usage and clinical outcomes.
Further studies are needed to validate outcomes of multidisciplinary GDMT clinics.
Keywords
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Article info
Publication history
Published online: September 08, 2022
Accepted:
August 20,
2022
Received in revised form:
July 26,
2022
Received:
April 15,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
