Heart failure (HF) significantly impacts about 1.2% of the population in Hong Kong, leading to approximately 20,000 related hospitalizations annually. If left untreated, the 5-year mortality rate for HF can exceed 50%. Guideline-directed medical therapy (GDMT) is crucial, as it has been proven to reduce mortality, decrease hospitalizations, and enhance the quality of life in HF patients. Despite its proven efficacy, the optimization of GDMT presents real-world challenges due to several clinical difficulties and barriers.
This presentation will explore the various obstacles in maximizing GDMT for HF patients, categorizing them into patient factors, physician factors, and system factors. Patient factors include a lack of awareness and understanding about the severity of HF, leading to hesitation in adjusting or increasing medication. From the physician's perspective, non-cardiology specialists, primarily general practitioners, may underutilize essential medications due to concerns about potential side effects. Systemically, the lack of established care protocols for patients transitioning from hospital to home after episodes of acute decompensated heart failure and the long intervals between follow-up appointments in busy clinics hinder the timely uptitration of GDMT.
In conclusion, effectively optimizing GDMT is vital for improving HF outcomes but is fraught with challenges. By acknowledging and addressing these impediments, healthcare providers can enhance the implementation of evidence-based practices and improve overall management of heart failure. This effort will not only tackle the immediate barriers but also pave the way for a more comprehensive approach to heart failure care, ultimately leading to improved patient outcomes.
