Language

English

Publication Date

6-26-2025

Journal

World Journal of Cardiology

DOI

10.4330/wjc.v17.i6.107102

PMID

40575420

PMCID

PMC12186193

PubMedCentral® Posted Date

6-26-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Significant gaps in guideline-directed medical therapy (GDMT) for heart failure (HF) stem from shortages of cardiologists and advanced HF providers, as well as a lack of optimal HF management knowledge among hospitalists. This study compared the impact of optimal medical therapy in HF (OMT-HF) certification on GDMT implementation and patient outcomes between an intervention group (IG) of hospitalists and a standard-of-care comparison group (SOC-CG).

Aim: To evaluate if OMT-HF has a difference in GDMT and patients in outcomes between IG and SOC-CG.

Methods: This study was implemented from November 2022 to May 2023. Hospitalized cardiology patients with HF and left ventricular ejection fraction ≤ 40% were randomized to IG or SOC-CG. Exclusion criteria included patients in cardiogenic shock, unable to consent, or at high risk. Follow-up was at 30 days post-discharge. Differences between groups were analyzed using Fisher's exact test for categorical variables and Wilcoxon rank-sum or unpaired t-test for continuous variables. Changes in Minnesota Living with Heart Failure Questionnaire (MLWHFQ) scores were evaluated using a paired t-test.

Results: IG patients had lower readmission rates [(9 (42.85%) vs 11 (17.46%), P = 0.03] and a decreased trend in mortality 30-day post discharge. IG patients also showed greater mean improvements in total (-27.03 ± 24.59 vs -5.85 ± 23.52, P < 0.001), physical (-13.8 ± 12.3 vs -2.71 ± 11.16, P < 0.001) and emotional (-4.76 ± 8.10 vs -1.42 ± 5.98) dimensions on the MLWHFQ compared to SOC-CG, however, change in emotional dimension did not reach statistical significance.

Conclusion: Hospitalist OMT-HF certification may lead to better 30-day outcomes in hospitalized HF patients including quality of life, mortality and readmission rates. Larger prospective studies are warranted to validate these findings.

Keywords

Heart failure education optimization, Guideline directed medical therapy, Heart failure, Quality of Life, Optimal medical therapy in heart failure

Published Open-Access

yes

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