Evaluating the Effectiveness of Guideline-Directed Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction at Hanoi Heart Hospital

Abstract

Objectives: This study aimed to evaluate the effectiveness of adherence to evidence-based prescribing in patients with heart failure with reduced ejection fraction (HFrEF) at Hanoi Heart Hospital. Methods: A retrospective study was conducted, collecting data from patients during both inpatient and outpatient treatment phases. Adherence to Guideline-Directed Medical Therapy (GDMT) was calculated using the scoring system from the QUALIFY study. Hospitalizations were identified through outpatient medical records. Results: The study included 360 HFrEF patients. At the time of discharge, 95% of patients were prescribed at least one GDMT medication. During the outpatient phase, 97.9% of patients were prescribed at least one GDMT drug class, and 93.9% were prescribed at least two classes. GDMT adherence scores showed a progressive increase from the time of discharge to one month post-discharge. Poor adherence to GDMT was significantly associated with a elevation in all-cause and heart failure-related hospitalizations within 12 months following discharge (p < 0,05). Conclusions: Poor adherence to GDMT is associated with an increased risk of heart failure-related readmission within 12 months. Patients should be prescribed evidence-based heart failure therapies, with dosages titrated toward target levels or the maximum tolerated doses to improve clinical outcomes.