Patients with heart failure who don’t receive optimal treatment as per established guidelines are at a higher risk of costly and sometimes fatal outcomes, according to new research from Baylor College of Medicine.
The study, published in the Journal of the American College of Cardiology: Heart Failure, revealed that 28% of patients died within a year following a first-time hospitalization for heart failure.
Heart Failure Patients: Treatment & Outcome
“These are heart failure patients who were sicker than ambulatory heart failure patients and required a hospital stay,” said Dr. Biykem Bozkurt, professor of medicine—cardiology and researcher with the Cardiovascular Research Institute at Baylor.
“Most patients were not optimally treated with lifesaving therapies following hospitalization. It is a huge lost opportunity for saving lives and changing the trajectory of heart failure.”
The study evaluated over 250,000 patients and found that those who later died or had to be re-hospitalized within the next year received inadequate dosing or combinations of treatments and experienced a delay in treatment initiation.
Guidelines for Treatment & Cost Implication
Bozkurt highlighted the problem of not adhering to the heart failure treatment guidelines, equating it to a cancer patient not starting chemotherapy promptly.
Non-adherence and delays in treatment not only increase the risk of death and rehospitalizations but also lead to higher healthcare costs due to complications like kidney disease, a common issue in heart failure patients.
“Adherence to medications and proper implementation not only lessen hospitalizations but they actually slow the decline of kidney disfunction in heart failure patients.
So not only would lives be saved, but rehospitalization could be reduced, lowering healthcare costs,” Bozkurt explained.
Proposed Strategies
To address these issues, the researchers suggested the following strategies:
- Initiation of treatment before discharge from the hospital.
- A coordinated care system for continuous treatment, such as a post-discharge clinic or virtual follow-up appointments.
- Partnerships between specialists and primary care providers.
- Use of electronic health record alerts to monitor medication dosages and timelines.
Bozkurt stressed that patient adherence to treatment plans is also crucial.
“It may seem like a lot of medication to some, but they are proven to be an effective and safe way to improve survivorship and reduce hospitalizations,” Bozkurt said.
“They should not view this as a pill burden; if anything, it should be viewed as the ammunition needed to improve symptoms, quality of life, well-being and reduce the risk of cardiovascular death and hospitalizations.”
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The study was published in JACC: Heart Failure.
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