Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2022 May 11;12(1):7730. doi: 10.1038/s41598-022-11740-5.
This Korean nationwide, multicenter, noninterventional, prospective cohort study aimed to analyze physician adherence to guideline-recommended therapy for heart failure (HF) with reduced ejection fraction (HFrEF) and its effect on patient-reported outcomes (PROs). Patients diagnosed with or hospitalized for HFrEF within the previous year were enrolled. Treatment adherence was considered optimal when all 3 categories of guideline-recommended medications (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or angiotensin receptor-neprilysin inhibitors; beta-blockers; and mineralocorticoid receptor antagonists) were prescribed and suboptimal when ≤ 2 categories were prescribed. The 36-Item Short Form Survey (SF-36) scores were compared at baseline and 6 months between the 2 groups. Overall, 854 patients from 30 hospitals were included. At baseline, the optimal adherence group comprised 527 patients (61.7%), whereas during follow-up, the optimal and suboptimal adherence groups comprised 462 (54.1%) and 281 (32.9%) patients, respectively. Patients in the suboptimal adherence group were older, with a lower body mass index, and increased comorbidities, including renal dysfunction. SF-36 scores were significantly higher in the optimal adherence group for most domains (P < 0.05). This study showed satisfactory physician adherence to contemporary treatment for HFrEF. Optimal adherence to HF medication significantly correlated with better PROs.
这项韩国全国性、多中心、非干预性、前瞻性队列研究旨在分析医生对射血分数降低型心力衰竭（HFrEF）的指南推荐治疗的依从性及其对患者报告结局（PROs）的影响。研究纳入了过去一年中被诊断为 HFrEF 或因 HFrEF 住院的患者。当所有 3 类指南推荐药物（血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂或血管紧张素受体脑啡肽酶抑制剂；β受体阻滞剂；和盐皮质激素受体拮抗剂）都被开处方时，治疗依从性被认为是最佳的，而当只开了 ≤ 2 类药物时，则被认为是次优的。在基线和 6 个月时，使用 36 项简短健康调查问卷（SF-36）评分比较了两组患者的 PROs。总体而言，来自 30 家医院的 854 名患者被纳入研究。在基线时，最佳依从组包括 527 名患者（61.7%），而在随访期间，最佳和次佳依从组分别包括 462 名（54.1%）和 281 名（32.9%）患者。次佳依从组的患者年龄更大，体重指数更低，合并症更多，包括肾功能不全。在大多数领域，最佳依从组的 SF-36 评分明显更高（P<0.05）。这项研究表明，医生对 HFrEF 的当代治疗有较好的依从性。HF 药物的最佳依从性与更好的 PROs 显著相关。
