Heart failure & cardiomyopathiesCohort study
Bridging the gap in heart failure management: the effect of a cross-disciplinary intervention on guidelines-directed medical therapy in primary care
- prospective quality improvement study
- cross-disciplinary implementation project
- before-after (6 months before and after the intervention)
Authors' conclusion
The HISS study demonstrates that a cross-disciplinary, case-based educational intervention was associated with improved GDMT adherence (especially SGLT2i and ARNI) and reduced ambulatory healthcare utilization in primary care patients with chronic stable HF. These findings underscore the importance of bridging the gap between specialist and primary care to optimize HF management.
Study context
- Population
- Primary care patients diagnosed with heart failure (HF) in southern Sweden, 2021–2023patients diagnosed with HF (mean age 79 years) from twenty primary health care centres
- Participants
- 587 patients
- Exposure
- Medication use and healthcare contacts 6 months before and after the intervention
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
GDMT use (quadruple therapy), HFmrEF · increased post-intervention
P = 0.020
SGLT2i uptake, all HF types
- Improved significantly across all HF types
Angiotensin receptor-neprilysin inhibitors (ARNI) use, HF with reduced ejection fraction (HFrEF)
- Increased among HFrEF patients
Beta-blocker use, HF with preserved ejection fraction
- Declined
Ambulatory healthcare contacts
- Total number decreased following the intervention
Hospitalizations
- Remained unchanged
Original publication
Summarised from the published abstract; every number is checked against it