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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
Summary
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.
Keywords:
AsiaGet With The Guidelinesguideline‐directed medical therapyhealth policyheart failurequality improvementMore Related Videos
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