Abstract 16493: An Evaluation of Heart Failure Management in the Non-White Population at a Safety Net Hospital Compared to a National Registry

Abstract

Introduction: The importance of guideline-directed medical therapy (GDMT) to improve outcomes in patients with heart failure has been proven in multiple studies. However, providers still fall short in prescribing these medications to heart failure patients. This is reflected in the CHAMP-HF registry, one of the largest registries utilized to observe and analyze the use of GDMT for heart failure. The CHAMP-HF registry population includes 3,518 patients from 150 U.S. primary care and cardiology practices. Of this population, approximately 25.1% are non-White. It remains unclear what GDMT treatment patterns are in a majority non-White population. Objective: This study aims to compare GDMT treatment patterns for heart failure at Harbor-UCLA Heart Failure (HUCLA HF) clinic, with a majority-minority population, to the CHAMP-HF registry published data. Methods: This prospective cohort study followed patients who visited the HUCLA HF clinic over four months. Providers used a checklist to prompt them to review each patient’s GDMT at the end of each visit. Patient demographic data and checklist data were entered into the HUCLA HF clinic registry. The registry was used to analyze the utilization of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB), angiotensin receptor neprilysin inhibitor (ARNI), beta-blocker, and mineralocorticoid receptor antagonist (MRA). The percentage of patients using GDMT was compared to those in the CHAMP-HF registry. Results: Overall, the HUCLA HF clinic registry revealed a majority-minority patient population with about 91% of patients classified as non-White patients. The HUCLA HF clinic patients had a higher percentage on max ACE/ARB (21% vs 15.7%), max ARNI therapy (42% vs 13.8%), max beta-blocker therapy (47% vs 15.5%), and max MRA therapy (70% vs 14.5%) compared to the non-White population in the CHAMP-HF registry, respectfully. Conclusions: This study demonstrates greater utilization of GDMT at the HUCLA HF clinic compared to the patients in the CHAMP-HF registry. This difference was likely due to the checklist that reminded the provider to review the GDMT at each visit. Strategies that prompt clinicians to review GDMT must be implemented to maximize its use.