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Titel: Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry
VerfasserIn: Komajda, Michel
Schöpe, Jakob
Wagenpfeil, Stefan
Tavazzi, Luigi
Böhm, Michael
Ponikowski, Piotr
Anker, Stefan D
Filippatos, Gerasimos S
Cowie, Martin R
Sprache: Englisch
Titel: European journal of heart failure
Bandnummer: 21
Heft: 7
Seiten: 921-929
Verlag/Plattform: Wiley
Erscheinungsjahr: 2019
Freie Schlagwörter: Heart failure
Guidelines
Adherence
Medication
Dosage
Outcomes
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Physicians' adherence to guideline-recommended therapy is associated with short-term clinical outcomes in heart failure (HF) with reduced ejection fraction (HFrEF). However, its impact on longer-term outcomes is poorly documented. Here, we present results from the 18-month follow-up of the QUALIFY registry. Data at 18 months were available for 6118 ambulatory HFrEF patients from this international prospective observational survey. Adherence was measured as a continuous variable, ranging from 0 to 1, and was assessed for five classes of recommended HF medications and dosages. Most deaths were cardiovascular (CV) (228/394) and HF-related (191/394) and the same was true for unplanned hospitalizations (1175 CV and 861 HF-related hospitalizations, out of a total of 1541). According to univariable analysis, CV and HF deaths were significantly associated with physician adherence to guidelines. In multivariable analysis, HF death was associated with adherence level [subdistribution hazard ratio (SHR) 0.93, 95% confidence interval (CI) 0.87–0.99 per 0.1 unit adherence level increase; P = 0.034] as was composite of HF hospitalization or CV death (SHR 0.97, 95% CI 0.94–0.99 per 0.1 unit adherence level increase; P = 0.043), whereas unplanned all-cause, CV or HF hospitalizations were not (all-cause: SHR 0.99, 95% CI 0.9–1.02; CV: SHR 0.98, 95% CI 0.96–1.01; and HF: SHR 0.99, 95% CI 0.96–1.02 per 0.1 unit change in adherence score; P = 0.52, P = 0.2, and P = 0.4, respectively). These results suggest that physicians' adherence to guideline-recommended HF therapies is associated with improved outcomes in HFrEF. Practical strategies should be established to improve physicians' adherence to guidelines.
DOI der Erstveröffentlichung: 10.1002/ejhf.1459
URL der Erstveröffentlichung: https://onlinelibrary.wiley.com/doi/10.1002/ejhf.1459
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-403954
hdl:20.500.11880/36316
http://dx.doi.org/10.22028/D291-40395
ISSN: 1388-9842
1879-0844
Datum des Eintrags: 28-Aug-2023
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
Professur: M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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