Heart failure & cardiomyopathies
Interventions for Optimization of Guideline-Directed Medical Therapy: A Systematic Review
Authors' conclusion
Initiatives that used interdisciplinary teams, largely comprised of nurses and pharmacists, most consistently led to improvements in GDMT.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF)
- Participants
- 19,840 patients28 RCTs
- Comparison
- System-level quality improvement interventions vs usual care
- Outcome
- GDMT use
Methodological detailsPubMed, Embase, Cochrane, CINAHL, Web of Science, January 2010 to November 2023, Bias assessed with Cochrane Risk of Bias tool and Oxford Centre for Evidence-Based Medicine
- PubMed, Embase, Cochrane, CINAHL, Web of Science, January 2010 to November 2023
- Bias assessed with Cochrane Risk of Bias tool and Oxford Centre for Evidence-Based Medicine
Pooled result
As reported in the abstract
Proportion of patients on target doses of GDMT
Interdisciplinary titration clinics vs usual care: greater proportion on target doses of β-blockers
10% to 60%
Interdisciplinary titration clinics vs usual care: greater proportion on target doses of renin-angiotensin-aldosterone system inhibitors
2% to 53%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Interventions for Optimization of Guideline-Directed Medical Therapy: A Systematic Review. JAMA Cardiol. Published 1 April 2024. doi:10.
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