Improving Heart Failure Quality of Care Over the First Twenty Years: The Get With The Guidelines-Heart Failure...

Area of Science:

• Cardiology
• Health Services Research
• Quality Improvement

Background:

• The Get With the Guidelines-Heart Failure program, established in 2005, aims to enhance care for hospitalized heart failure patients.
• This initiative represents a national effort to standardize and improve treatment protocols.

Purpose of the Study:

• To evaluate the impact of the Get With the Guidelines-Heart Failure program on patient care and outcomes over its first two decades (2005-2024).
• To assess temporal trends in adherence to quality measures and the adoption of new therapies for heart failure.

Main Methods:

• Analysis of over 1.5 million patient records from 819 hospitals participating in the Get With the Guidelines-Heart Failure program (2005-2024).
• Utilized multivariable regression to examine changes in quality metrics, medication prescriptions, and in-hospital outcomes.
• Adjusted for patient and hospital characteristics to isolate program effects.

Main Results:

• Significant improvement in an all-or-none composite achievement metric (76.1% to 88.7%), alongside increased use of mineralocorticoid receptor antagonists (27.4% to 80.9%).
• High adoption rates for new heart failure therapies, including angiotensin receptor-neprilysin inhibitors (67.3%) and sodium-glucose cotransporter-2 inhibitors (78.2%) by 2024.
• Improvements noted in post-discharge follow-up and anticoagulation for atrial fibrillation; however, vaccination and implantable cardioverter-defibrillator use declined recently.

Conclusions:

• The Get With the Guidelines-Heart Failure program has demonstrated sustained improvements in heart failure care quality over two decades.
• The program facilitated the increased prescription of guideline-directed medical therapies and rapid integration of novel medications, positively impacting patient management.