Quality of Physician Adherence to Guideline Recommendations for Life-saving Treatment in Heart Failure: an International Survey

Abstract

QUALIFY (QUality of Adherence to guideline recommendations for LIFe-saving treatment in heart failure surveY) showed that good physician adherence to guideline recommendations for angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta blockers, mineralocorticoid receptor antagonists and ivabradine, with prescription of at least 50 % of recommended dosages, was associated with better 6-month outcomes than moderate or poor adherence. Poor adherence was associated with higher all-cause mortality (hazard ratio 2.21; 95 % CI [1.42–3.44]; p=0.001) and combined heart failure hospitalisation or death (hazard ratio 1.26; 95 % CI [1.08–1.71]; p=0.024) compared with good adherence. Heart failure hospitalisation is a good opportunity to review a patient’s medication and to optimise guideline adherence.