Bridging Treatment Implementation Gaps in Patients With Heart Failure: JACC Focus Seminar 2/3

Area of Science:

• Cardiology
• Health Services Research
• Implementation Science

Background:

• Heart failure (HF) significantly impacts older adults, despite available guideline-directed medical therapies (GDMTs).
• Suboptimal implementation of proven GDMTs contributes to the high burden of HF.
• Current approaches to closing care gaps have often been ineffective.

Purpose of the Study:

• To review effective implementation interventions for increasing GDMT uptake in heart failure.
• To discuss barriers and facilitators influencing the implementation of HF treatments.
• To propose strategies for trial design and an evidence-to-care model to improve long-term implementation.

Main Methods:

• Systematic review and synthesis of implementation science literature.
• Analysis of barriers and facilitators to GDMT adoption.
• Development of a conceptual model for evidence generation and implementation.

Main Results:

• Many strategies to improve GDMT uptake in HF have been ineffective.
• Effective interventions exist but are underutilized.
• Implementation science frameworks can guide better knowledge translation.

Conclusions:

• Adopting implementation science principles is vital for reducing the global burden of heart failure.
• A coordinated approach involving policymakers, researchers, and clinicians can improve GDMT delivery.
• The proposed evidence-to-care model aims to integrate evidence generation with sustained implementation.