Initiation, Adherence, and Persistence to Guideline-Directed Medical Therapy After Heart Failure Hospitalization

How frequently is guideline-directed medical therapy prescribed by inpatient clinicians and continued to be taken by patients through the 6 months following a heart failure (HF) hospitalization? In this cohort study of 6111 patients hospitalized for HF, 54% of new prescriptions for guideline-directed medical therapy went unfilled within 7 days of discharge. At 1 month postdischarge, 22% of the newly initiated prescriptions had been discontinued; at 6 months, adherence was 42% and persistence was 51% for all discharge medications. Results of this study suggest that HF quality-improvement initiatives have focused on initiation of guideline-directed medical therapy at hospital discharge and highlights a need to develop interventions to support patients’ medication use beyond the initial discharge prescription.

Corresponding Author: Timothy S. Anderson, MD, MAS, Division of General Internal Medicine, University of Pittsburgh, 3609 Forbes Ave, 2nd Floor, Pittsburgh, PA 15213 (tsander@pitt.edu).

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