PMID- 28463464
OWN - NLM
STAT- MEDLINE
DCOM- 20180615
LR  - 20180621
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 19
IP  - 11
DP  - 2017 Nov
TI  - Physicians' guideline adherence is associated with better prognosis in
      outpatients with heart failure with reduced ejection fraction: the QUALIFY
      international registry.
PG  - 1414-1423
LID - 10.1002/ejhf.887 [doi]
AB  - AIMS: To evaluate the impact of physicians' adherence to guideline-recommended
      medications for heart failure with reduced ejection fraction (HFrEF), including
      >/=50% prescription of recommended doses, on clinical outcomes at 6-month
      follow-up. METHODS AND RESULTS: In QUALIFY, an international, prospective,
      observational, longitudinal survey, 6669 outpatients with HFrEF were recruited
      1-15 months after heart failure (HF) hospitalization from September 2013 to
      December 2014 in 36 countries and followed up at 6 months. A global adherence to 
      guidelines score was developed for prescription of angiotensin-converting enzyme 
      inhibitors (ACEIs), angiotensin receptor blockers (ARBs), beta-blockers (BBs),
      mineralocorticoid receptor antagonists (MRAs) and ivabradine and their dosages.
      Baseline global adherence score was good in 23% of patients, moderate in 55%, and
      poor in 22%. At 6-month follow-up, poor adherence was associated with
      significantly higher overall mortality [hazard ratio (HR) 2.21, 95% confidence
      interval (CI) 1.42-3.44, P=0.001], cardiovascular mortality (HR 2.27, 95% CI
      1.36-3.77, P=0.003), HF mortality (HR 2.26, 95% CI 1.21-4.2, P=0.032), combined
      HF hospitalization or HF death (HR 1.26, 95% CI 1.08-1.71, P=0.024) and
      cardiovascular hospitalization or cardiovascular death (HR 1.35, 95% CI
      1.08-1.69, P=0.013). There was a strong trend between poor adherence and HF
      hospitalization (HR 1.32, 95% CI 1.04-1.68, P=0.069). CONCLUSION: Good adherence 
      to pharmacologic treatment guidelines for ACEIs, ARBs, BBs, MRAs and ivabradine, 
      with prescription of at least 50% of recommended dosages, was associated with
      better clinical outcomes during 6-month follow-up. Continuing global educational 
      initiatives are needed to emphasise the importance of guideline recommendations
      for optimising drug therapy and prescribing evidence-based doses in clinical
      practice.
CI  - (c) 2017 The Authors. European Journal of Heart Failure (c) 2017 European Society
      of Cardiology.
FAU - Komajda, Michel
AU  - Komajda M
AD  - Institute of Cardiometabolism and Nutrition (ICAN), Pierre et Marie Curie
      University, Paris VI, La Pitie-Salpetriere Hospital, Paris, France.
FAU - Cowie, Martin R
AU  - Cowie MR
AD  - Imperial College London, Royal Brompton Hospital, London, UK.
FAU - Tavazzi, Luigi
AU  - Tavazzi L
AD  - Maria Cecilia Hospital, GVM Care & Research, Ettore Sansavini Health Science
      Foundation, Cotignola, Italy.
FAU - Ponikowski, Piotr
AU  - Ponikowski P
AD  - Medical University, Faculty of Public Health, Wroclaw, Poland.
FAU - Anker, Stefan D
AU  - Anker SD
AD  - Innovative Clinical Trials, Department of Cardiology and Pneumology, University
      Medical Center Gottingen (UMG), Gottingen, Germany.
FAU - Filippatos, Gerasimos S
AU  - Filippatos GS
AD  - National and Kapodistrian University of Athens, School of Medicine, Athens
      University Hospital Attikon, Athens, Greece.
CN  - QUALIFY Investigators
LA  - eng
SI  - ISRCTN/ISRCTN87465420
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20170430
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Mineralocorticoid Receptor Antagonists)
SB  - IM
CIN - Eur J Heart Fail. 2017 Nov;19(11):1424-1426. PMID: 28786154
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Angiotensin Receptor Antagonists/therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Drug Prescriptions/*standards
MH  - Female
MH  - Follow-Up Studies
MH  - Global Health
MH  - *Guideline Adherence
MH  - Heart Failure/epidemiology/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mineralocorticoid Receptor Antagonists/therapeutic use
MH  - Morbidity/trends
MH  - *Outpatients
MH  - Physicians/*standards
MH  - *Practice Patterns, Physicians'
MH  - Prognosis
MH  - Prospective Studies
MH  - Registries
MH  - Stroke Volume/*physiology
OTO - NOTNLM
OT  - *Adherence
OT  - *Dosage
OT  - *Guidelines
OT  - *Heart failure with reduced ejection fraction
OT  - *Medication
OT  - *Outcomes
EDAT- 2017/05/04 06:00
MHDA- 2018/06/16 06:00
CRDT- 2017/05/03 06:00
PHST- 2017/04/05 00:00 [received]
PHST- 2017/04/14 00:00 [revised]
PHST- 2017/04/17 00:00 [accepted]
PHST- 2017/05/04 06:00 [pubmed]
PHST- 2018/06/16 06:00 [medline]
PHST- 2017/05/03 06:00 [entrez]
AID - 10.1002/ejhf.887 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2017 Nov;19(11):1414-1423. doi: 10.1002/ejhf.887. Epub 2017 Apr
      30.