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Implementation of the Get With The Guidelines-Heart Failure Adherence to Science, Implementation in Asia (GWTG-HF

Hung-Yu Chang1,2, Chia-Te Liao3, Paul A Heidenreich4

  • 1Heart Center Cheng Hsin General Hospital Taipei Taiwan.

Journal of the American Heart Association
|December 18, 2025
PubMed

Insights

Participation in the Get With The Guidelines-Heart Failure Adherence to Science, Implementation in Asia (GWTG-HF A.S.I.A.) program significantly increased guideline-directed medical therapy (GDMT) use in Taiwan. This quality improvement initiative improved heart failure care and reduced patient loss to follow-up.

Area of Science:

  • Cardiology
  • Health Services Research
  • Clinical Quality Improvement

Background:

  • Guideline-directed medical therapy (GDMT) is crucial for heart failure with reduced ejection fraction (HFrEF) but adoption in Asia is low.
  • The Get With The Guidelines-Heart Failure Adherence to Science, Implementation in Asia (GWTG-HF A.S.I.A.) program was launched to address this gap.
  • This study evaluates the impact of the GWTG-HF A.S.I.A. program on GDMT implementation in Taiwan.

Purpose of the Study:

  • To assess the association between participation in the GWTG-HF A.S.I.A. program and the implementation of GDMT for HFrEF patients in Taiwan.
  • To compare GDMT prescription rates between participating and non-participating hospitals.
  • To evaluate secondary outcomes including echocardiographic remodeling, loss to follow-up, and mortality.

Main Methods:

  • Analysis of 1991 HFrEF patients from the Taiwan Society of Cardiology HF Registry (2021-2024).
  • Comparison of 4 participating hospitals with 23 non-participating control hospitals.
  • Propensity-score matching and generalized estimating equations to compare GDMT prescription trends and outcomes.

Main Results:

  • GDMT use increased in both groups, with significantly greater increases in participating hospitals (aOR 2.73 for 4-pillar GDMTs).
  • Program participation was associated with higher rates of angiotensin receptor-neprilysin inhibitors, SGLT2 inhibitors, and mineralocorticoid receptor antagonists.
  • Participating hospitals demonstrated improved left-ventricular reverse remodeling and significantly lower loss to follow-up (0.5% vs. 5.2%).

Conclusions:

  • The GWTG-HF A.S.I.A. program effectively increased GDMT prescription rates in Taiwanese hospitals.
  • Structured quality improvement initiatives are vital for bridging the evidence-practice gap in cardiovascular care in Asia.
  • The program showed positive impacts on patient outcomes beyond medication adherence.
Abstract

Keywords:
AsiaGet With The Guidelinesguideline‐directed medical therapyhealth policyheart failurequality improvement

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