{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:01:53Z","timestamp":1792123313568,"version":"4.4.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":684,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011772","name":"Novartis Farma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011772","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011772","name":"Novartis Farmac\u00e9utica","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011772","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The current European Society of Cardiology (ESC) guidelines provide clear indications for the treatment of acute and chronic heart failure (HF). Nevertheless, there is a constant need for real-world evidence regarding the effectiveness, adherence, and persistence of drug therapy. We investigated the use of sacubitril\/valsartan for the treatment of HF with reduced ejection fraction in real-world clinical practice in Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>An observational, retrospective, non-interventional cohort study based on electronic medical records from nine specialized hospital HF centres in Italy was carried out on patients with prescription of sacubitril\/valsartan. Overall, 948 patients had a prescription of sacubitril\/valsartan, with 924 characterized over 6 months and followed up for 12 months. Pharmacoutilization data at 1 year of follow-up were available for 225 patients {mean age 69.7 years [standard deviation (SD) = 10.8], 81.8% male}. Of those, 398 (45.2%) reached the target dose of sacubitril\/valsartan of 97\/103 mg in a mean time of 6.9 (SD = 6.2) weeks. Blood pressure and hypotension in 61 patients (65%) and worsening of chronic kidney disease in 10 patients (10.6%) were the main reasons for not reaching the target dose. Approximatively 50% of patients had a change in sacubitril\/valsartan dose during follow-up, and 158 (70.2%) were persistent with the treatment during the last 3 months of follow-up. A sensitivity analysis (persistence during the last 4 months of follow-up) showed persistence for 162 patients (72.0%). Adherence data, available for 387 patients, showed full adherence for 205 (53%). Discontinuation (102\/717 patients, 14.2%) was mainly due to hypotension and occurred after a mean time of 34.3 (SD = 28.7) weeks. During follow-up, out of 606 patients with available data, 434 patients (71.6%) had an HF add-on drug or drugs concomitant with sacubitril\/valsartan. HF-related hospitalization during follow-up was numerically higher in non-persistent (16\/67 patients, 23.9%) vs. patients persistent to sacubitril\/valsartan (30\/158, 19%) (P = 0.405).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Real-world data on the use of sacubitril\/valsartan in clinical practice in Italy show a rapid titration to the target dose, high therapeutic adherence enabling a good level of therapeutic management in line with ESC guidelines for patients with reduced ejection fraction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14600","type":"journal-article","created":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T12:04:21Z","timestamp":1701518661000},"page":"456-465","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pharmacoutilization and Adherence to Sacubitril\/Valsartan in Real World: The REAL.IT Study in HFrEF"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9613-5062","authenticated-orcid":false,"given":"Massimo","family":"Iacoviello","sequence":"first","affiliation":[{"name":"Surgical and Medical Sciences Department, University of Foggia , Foggia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Di Gesaro","sequence":"additional","affiliation":[{"name":"U.O. Cardiologia IRCCS ISMETT Palermo , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo Maria","family":"Sarullo","sequence":"additional","affiliation":[{"name":"U.O.S. Di Riabilitazione Cardiovascolare Ospedale Buccheri La Ferla Fatebenefratelli , Palermo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Miani","sequence":"additional","affiliation":[{"name":"SOC Cardiologia, Dipartimento Cardiotoracico, Azienda Sanitaria Universitaria Friuli Centrale, Ospedale S. Maria della Misericordia , Udine ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Driussi","sequence":"additional","affiliation":[{"name":"SOC Cardiologia, Dipartimento Cardiotoracico, Azienda Sanitaria Universitaria Friuli Centrale, Ospedale S. Maria della Misericordia , Udine ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Correale","sequence":"additional","affiliation":[{"name":"SC Universitaria di Cardiologia AOU \u2018Ospedali Riuniti\u2019 Foggia , Foggia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Bilato","sequence":"additional","affiliation":[{"name":"U.O.C. Cardiologia Azienda ULSS 8 Berica - Ospedali dell'Ovest Vicentino , Arzignano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Passantino","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Cardiac Rehabilitation, U.O. Cardiologia ICS Maugeri SpA SB Bari, IRCCS Istituto di Bari , Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erberto","family":"Carluccio","sequence":"additional","affiliation":[{"name":"Cardiologia e Fisiopatologia Cardiovascolare, Azienda Ospedaliera Universitaria \u2018Santa Maria della Misericordia\u2019 , Perugia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Villani","sequence":"additional","affiliation":[{"name":"UO Cardiologia, Istituto AuxologicoItaliano IRCCS, Dipartimento di Scienze Cardiovascolari, Neurologiche, Metaboliche , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"degli Esposti","sequence":"additional","affiliation":[{"name":"CEO of CliCon S.r.l. Societ\u00e0 Benefit , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"d'Agostino","sequence":"additional","affiliation":[{"name":"Novartis Farma SpA , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Peruzzi","sequence":"additional","affiliation":[{"name":"Novartis Farma SpA , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Poli","sequence":"additional","affiliation":[{"name":"Novartis Farma SpA , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"di Lenarda","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, University Hospital and Health Services of Trieste , Trieste 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