{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:13:56Z","timestamp":1789902836046,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1774,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011725","name":"Servier","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011725","name":"Servier","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Failure to prescribe key medicines at evidence-based doses is associated with increased mortality and hospitalization for patients with Heart Failure with reduced Ejection Fraction (HFrEF). We assessed titration patterns of guideline-recommended HFrEF medicines internationally and explored associations with patient characteristics in the global, prospective, observational, longitudinal registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Data were collected from September 2013 through December 2014, with 7095 patients from 36 countries [&amp;gt;18 years, previous HF hospitalization within 1\u201315 months, left ventricular ejection fraction (LVEF) \u2264 40%] enrolled, with dosage data at baseline and up to 18 months from 4368 patients. In 4368 patients (mean age 63 \u00b1 17 years, 75% male) \u2265 100% target doses at baseline: 30.6% (ACEIs), 2.9% (ARBs), 13.9% (BBs), 53.8% (MRAs), 26.2% (ivabradine). At final follow-up, \u2265100% target doses achieved in more patients for ACEI (34.8%), BB (18.0%), and ivabradine (30.5%) but unchanged for ARBs (3.2%) and MRAs (53.7%). Adjusting for baseline dosage, uptitration during follow-up was more likely with younger age, higher systolic blood pressure, and in absence of chronic kidney disease or diabetes for ACEIs\/ARBs; younger age, higher body mass index, higher heart rate, lower LVEF, and absence of coronary artery disease for BBs. For ivabradine, uptitration was more likely with higher resting heart rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The international QUALIFY Registry suggests that few patients with HFrEF achieve target doses of disease-modifying medication, especially older patients and those with co-morbidity. Quality improvement initiatives are urgently required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13237","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T01:52:24Z","timestamp":1613008344000},"page":"861-871","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Patient Factors Associated with Titration of Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction: Data from the QUALIFY International Registry"],"prefix":"10.1093","volume":"8","author":[{"given":"Martin R.","family":"Cowie","sequence":"first","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London (Royal Brompton Hospital) , Dovehouse Street, London, SW3 6LY ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Sch\u00f6pe","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University , Campus Homburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Wagenpfeil","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University , Campus Homburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, GVM Care & Research , Cotignola ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III, Universit\u00e4tsklinikum des Saarlandes, Universit\u00e4t des Saarlandes Homburg , Saar ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Center for Heart Diseases, University Hospital, Medical University , Wroclaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology & Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Charit\u00e9-Universit\u00e4tsmedizin Berlin (Campus CVK) , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos S.","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National and Kapodistrian University of Athens, School of Medicine, Athens University Hospital Attikon , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Komajda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Saint Joseph Hospital , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"QUALIFY Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"key":"2026012115073930300_ehf213237-bib-0001","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1002\/ejhf.1594","article-title":"Survival of patients with chronic heart failure in the community: a systematic review and meta-analysis","volume":"21","author":"Jones","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026012115073930300_ehf213237-bib-0002","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1001\/jamacardio.2019.3593","article-title":"Temporal trends and patterns in mortality after incident heart failure: a longitudinal analysis of 86 000 individuals","volume":"4","author":"Conrad","year":"2019","journal-title":"JAMA Cardiol"},{"key":"2026012115073930300_ehf213237-bib-0003","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). 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