{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:49:04Z","timestamp":1790887744332,"version":"4.1.0"},"reference-count":69,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study was to synthesize the evidence on the effect of heart failure with reduced ejection fraction (HFrEF) pharmacotherapy on health\u2010related quality of life (HRQoL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We searched MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform in June 2020. Randomized placebo\u2010controlled trials evaluating contemporary HFrEF pharmacotherapy and reporting HRQoL as an outcome were included. Two reviewers independently assessed studies for eligibility, extracted data, and assessed risk of bias and GRADE certainty of evidence. The primary outcome was HRQoL at last available follow\u2010up analysed using a random\u2010effects model. We included 37 studies from 5770 identified articles. Risk of bias was low in 10 trials and high\/unclear in 27 trials. High certainty evidence from meta\u2010analyses demonstrated improved HRQoL over placebo with sodium\u2013glucose co\u2010transporter 2 (SGLT2) inhibitors [standardized mean difference (SMD) 0.16, 95% confidence interval (CI) 0.08\u20130.23] and intravenous iron (SMD 0.52, 95% CI 0.04\u20131.00). Furthermore, high certainty evidence from \u22651 landmark trial further supported improved HRQoL with angiotensin receptor blockers (ARBs) (SMD 0.09, 95% CI 0.02\u20130.17), ivabradine (SMD 0.14, 95% CI 0.04\u20130.23), hydralazine\u2013nitrate (SMD 0.24, 95% CI 0.04\u20130.44) vs. placebo, and for angiotensin receptor\u2013neprilysin inhibitor (ARNI) compared with an angiotensin\u2010converting enzyme (ACE) inhibitor (SMD 0.09, 95% CI 0.02\u20130.17). Findings were inconclusive for ACE inhibitors, beta\u2010blockers, digoxin, and oral iron based on low\u2010to\u2010moderate certainty evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ARBs, ARNIs, SGLT2 inhibitors, ivabradine, hydralazine\u2013nitrate, and intravenous iron improved HRQoL in patients with HFrEF. These findings can be incorporated into discussions with patients to enable shared decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2141","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T02:56:12Z","timestamp":1614308172000},"page":"578-589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Pharmacotherapy for heart failure with reduced ejection fraction and\n                    <scp>health\u2010related<\/scp>\n                    quality of life: a systematic review and\n                    <scp>meta\u2010analysis<\/scp>"],"prefix":"10.1093","volume":"23","author":[{"given":"Ricky D.","family":"Turgeon","sequence":"first","affiliation":[{"name":"Greg Moore Professorship in Clinical &amp; Community Cardiovascular Pharmacy, Faculty of Pharmaceutical Sciences University of British Columbia  Vancouver Canada"},{"name":"St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arden R.","family":"Barry","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences University of British Columbia  Vancouver Canada"},{"name":"Chilliwack General Hospital, Lower Mainland Pharmacy Services  Chilliwack Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel M.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula M.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Woodward Library University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8807"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.08.022"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.025"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2019.11.036"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.10.015"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-013-9394-7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911303"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.10.1295"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu385"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-2498(01)00298-4"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.028"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1071-9164(99)90030-1"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr404"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hft071"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044138"},{"key":"e_1_2_6_20_1","volume-title":"In: Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JPT","year":"2021"},{"key":"e_1_2_6_21_1","unstructured":"GRADE Working Group. 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