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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Published on: February 13, 2021

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

Peter A McCullough1, Hirsch S Mehta2, Colin M Barker3

  • 1Texas A&M College of Medicine, Dallas, TX, USA.

Journal of Comparative Effectiveness Research
|July 6, 2021
PubMed

Insights

Guideline-directed medical therapy (GDMT) significantly reduces healthcare utilization in patients with heart failure with reduced ejection fraction. Patients not on GDMT experienced higher hospitalizations, emergency visits, and longer hospital stays.

Area of Science:

  • Cardiology
  • Health Services Research

Background:

  • Heart failure with reduced ejection fraction (HFrEF) is a major cause of healthcare utilization.
  • Guideline-directed medical therapy (GDMT) aims to improve outcomes in HFrEF patients.
  • Real-world data on GDMT's impact on healthcare utilization is crucial.

Purpose of the Study:

  • To evaluate the effect of GDMT on healthcare utilization in HFrEF patients.
  • To compare healthcare utilization between HFrEF patients on GDMT and those not on GDMT.

Main Methods:

  • Retrospective analysis of the Optum Integrated File (2007-2020).
  • Patients were categorized into GDMT (beta blocker + ACE-I/ARB/ARNI) and non-GDMT cohorts.
  • Healthcare utilization metrics included hospitalizations, emergency department visits, and hospital days.

Main Results:

  • Patients not on GDMT had significantly higher annual all-cause hospitalizations (29% increase) and emergency department visits (26% increase).
  • Annualized hospital days were also longer for patients not on GDMT (1.88 vs 1.64 days).
  • These differences were statistically significant (p < 0.0001 for hospitalizations/ED visits, p = 0.0020 for hospital days).

Conclusions:

  • Optimal management with GDMT is associated with lower healthcare utilization in HFrEF.
  • Non-adherence to GDMT in HFrEF leads to increased healthcare resource consumption.
  • Real-world evidence supports the implementation of GDMT to reduce healthcare burden in HFrEF.

Keywords:
guideline directed medical therapyheart failurereduced ejection fractionutilization

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