Navigating between Scylla and Charybdis: challenges and strategies for implementing guideline-directed medical

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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

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Petar M Seferović1,2, Marija Polovina1,3, Christopher Adlbrecht4

  • 1Faculty of Medicine, Belgrade University, Belgrade, Serbia.

European Journal of Heart Failure
|November 10, 2021
PubMed

Insights

Guideline-directed medical therapy (GDMT) improves outcomes for heart failure with reduced ejection fraction (HFrEF). Overcoming barriers like patient factors, side effects, and healthcare access is key to optimizing GDMT.

Area of Science:

  • Cardiology
  • Pharmacology
  • Health Services Research

Background:

  • Guideline-directed medical therapy (GDMT) significantly reduces mortality and hospitalization in heart failure with reduced ejection fraction (HFrEF).
  • Real-world data reveal suboptimal GDMT implementation, with many HFrEF patients not receiving optimized treatment regimens requiring dose titration.
  • Barriers to GDMT include patient-related factors (comorbidities, age, adherence), treatment-related issues (intolerance, side effects), and healthcare system challenges (resource disparities, reimbursement, clinical inertia).

Purpose of the Study:

  • To review and propose evidence-based solutions for improving the comprehensive uptake of GDMT in HFrEF.
  • To discuss strategies for overcoming clinical inertia and enhancing GDMT implementation through professional education, patient empowerment, and multidisciplinary care.
  • To highlight the role of novel medications and tailored approaches in advancing GDMT strategies.

Main Methods:

  • Review of available evidence, practical experience, and expert consensus.
  • Discussion of evolving strategies, novel medications, and patient profiling for GDMT optimization.
  • Consideration of professional education, patient empowerment, multidisciplinary care, institutional accreditation, and modern technologies.

Main Results:

  • Professional education, patient empowerment, and multidisciplinary care are crucial for overcoming clinical inertia and boosting GDMT prescription and adherence.
  • Modern technologies can enhance professional and patient education and improve patient-provider communication.
  • Novel drugs, particularly sodium-glucose co-transporter 2 inhibitors, and tailored drug management represent evolving strategies for successful GDMT implementation.

Conclusions:

  • Optimizing GDMT in HFrEF requires addressing multifaceted barriers through innovative strategies and enhanced care models.
  • A comprehensive approach involving healthcare professionals, patients, and leveraging new technologies is essential for maximizing GDMT benefits.
  • The integration of novel pharmacotherapies and personalized treatment plans holds significant promise for improving HFrEF management.

Keywords:
Guideline-directed medical therapyHealth educationHeart failureMedication adherenceOptimal treatmentQuality of careSodium-glucose co-transporter 2 inhibitors

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