Unveiling the impact of an Indian-specific heart failure checklist on heart failure with reduced ejection fraction management in the South Indian population

Abstract

BackgroundThe study assessed the impact of the Indian Specific Heart Failure (ISHF) checklist, guided by healthcare professionals, on promoting guideline-directed medical therapy (GDMT), enhancing medication adherence, improving quality of life (QoL), and influencing clinical outcomes. MethodsThe study enrolled 200 HFrEF patients for one year, dividing them into control and intervention groups. The control group received standard treatment, while a specialized team administered the ISHF checklist to the intervention group. The ISHF checklist was a reminder tool to ensure GDMT adherence, provide personalized education, and conduct regular QoL assessments during follow-ups. Statistical analysis encompassed mean values, percentages, Chi-square tests, and linear regression models. Data analysis employed JAMOVI and R software. ResultsMedication adherence improved over 12 months (p ≤ 0.001), with higher GDMT usage in the intervention group (IG: 59.3% vs. CG: 40.6%). The intervention group showed improved ejection fraction over 12 months (29.1 ± 7.6 to 36.4 ± 8.1, p = 0.05), fewer rehospitalizations (IG: 30.4% vs. CG: 49.6%, p ≤ 0.001), and lower mortality (IG: 3.8% vs. CG: 8.3%, p = 0.05). The hazard ratio for mortality (HR 0.57) favoured the intervention, indicating reduced mortality risk. GDMT showed marginal significance in predicting QoL in the intervention group suggesting its potential influence on patient-reported outcomes in the IG (estimate = −5.41, SE = 2.76, p = 0.05). ConclusionThe ISHF checklist could facilitate smooth transitions, optimize GDMT usage, reduce readmissions and mortality rates, significantly elevate care standards, and provide substantial benefits to the healthcare system.