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Related Experiment Video

Updated: Jun 22, 2025

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

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

Published on: February 13, 2021

Novel Initiative Increasing GDMT Use Among Patients With Heart Failure With Reduced Ejection Fraction.

Andrei Minciunescu¹, Carolyn Rosner¹, David Kepplinger²

¹Inova Schar Heart and Vascular, Falls Church, Virginia, USA.

JACC. Heart Failure

|June 27, 2024

Summary

A quality improvement initiative significantly boosted the use of guideline-directed medical therapies, including angiotensin receptor-neprilysin inhibitors (ARNI) and mineralocorticoid receptor antagonists (MRA), for heart failure with reduced ejection fraction (HFrEF) patients.

Keywords:

angiotensin-neprilysin inhibitor guideline-directed medical therapy heart failure with reduced ejection fraction mineralocorticoid-receptor antagonist

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Published on: January 21, 2018

Area of Science:

Cardiology
Clinical Pharmacy
Quality Improvement Science

Background:

Guideline-directed medical therapy (GDMT) use in heart failure with reduced ejection fraction (HFrEF) is suboptimal despite proven benefits.
Initiatives to improve GDMT prescription rates are crucial for enhancing patient outcomes in HFrEF management.

Discussion:

A quality improvement project in a large cardiology practice focused on increasing the utilization of angiotensin receptor-neprilysin inhibitors (ARNI) and mineralocorticoid receptor antagonists (MRA) in HFrEF outpatients.
The initiative involved standardized patient identification and linked medication utilization rates to group quality metrics, setting targets for ARNI (>25%) and MRA (>60%) prescription.

Key Insights:

Following the initiative's implementation, ARNI utilization increased from 31% to 67%, and MRA utilization rose from 28% to 66% among eligible HFrEF patients.
The study highlights the effectiveness of establishing clear quality metrics and a proactive evaluation process in driving significant increases in GDMT prescription rates.

Outlook:

This model demonstrates a successful strategy for improving GDMT adherence in HFrEF, potentially applicable to other chronic conditions.
Future research could explore long-term impacts on patient morbidity and mortality and cost-effectiveness.