Abstract 12170: A National Heart Failure Initiative is Associated With Improved Use of Guideline-Directed Medical Therapies

Abstract

Background: Heart Failure (HF) is projected to impact over 8 million people by 2030. Guideline-Directed Medical Therapy (GDMT) reduces mortality and morbidity, but many eligible patients are not receiving the recommended medications. The 2022 ACC/AHA/HFSA Guideline for the Management of HF highlight the importance of SGLT2i and ARNi, which continue to be underused in eligible HFrEF patients. Methods: IMPLEMENT-HF (I-HF), a national HF quality improvement initiative focusing on early adoption of GDMT, aims to improve use of SGLT2i and ARNi for HFrEF patients. I-HF creates a transformative learning collaborative and resource repository across seven U.S regions to promote education and adherence to GDMT, that includes sharing models of clinical care, targeted training, resource development, and quality improvement consultation. Participation in a learning collaborative allows for sharing of interventions, such as adding SGLT2i on formulary, optimizing EHR tools for GDMT (best practice alerts, disease-specific order sets, dot phrases), provider education, and patient resources to address medication affordability. Sites receive educational materials, including webinars, pocket guideline booklets, and guideline reminder cards to reinforce GDMT. Participating hospitals collect GDMT data in Get With The Guidelines®-Heart Failure (GWTG-HF). ARNi and SGLT2i at discharge was analyzed from baseline (Q1 & Q2 2021 aggregate) through Q1 2022. Results: Data from 62 sites (16,533 HF patient records) showed that use of ARNi at hospital discharge increased from baseline 46% to 58% in Q1 2022, +12%, p value <0.001. SGLT2i use at discharge increased from 8% to 26%, +18%, p value <0.001 (Figure 1). Conclusions: Among centers participating in the I-HF initiative, early findings suggest there has been a rapid increase in use of SGLT2i and ARNi at discharge for HFrEF patients. Further study is needed to assess post-discharge GDMT use, adherence, and clinical outcomes.