{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T03:16:21Z","timestamp":1782962181359,"version":"3.54.5"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":402,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Translational Medicine Academy"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Clinical practice guidelines are commonly written by professional societies in high-income countries (HIC) with limited anticipation of implementation obstacles in other environments. We used heart failure (HF) guidelines as a paradigm to examine this concern, by conducting a survey to understand clinicians' ability to implement HF guidelines and their perceptions of the current HF guideline applicability in low- and middle-income countries (LMIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>An online survey of physicians in the database of the Translational Medicine Academy who treat HF patients was offered by email from 5 October to 27 November 2023, inquiring of participants' demographic information, experience, and views of HF guidelines as related to their practice. Of 2622 participating clinicians, 1592 partially completed, and an additional 1030 fully completed the survey. Participants were from 138 countries; 668 practiced in HIC, and 1954 in LMIC. Those from LMIC regarded HF guidelines to be less applicable in their country than did those from HIC (p\u2009=\u20090.0002). Of all those responding, 75.3% indicated that it was somewhat or mostly true that the HF guidelines were mostly applicable to HIC. Those from LMIC, but not HIC indicated that the greatest implementation obstacle was that the guidelines were for HIC (51.3% vs. 43.1%; p\u2009=\u20090.0387). A significantly higher proportion of respondents from LMIC indicated that resources for caring for their patients were somewhat or mostly limiting in most cases, than did those in HIC (41.6% vs. 32.5%, p\u2009=\u20090.0068).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This survey examined the widely-held thought that HF guidelines are broadly applicable to all regions of the world, concluding that such a perception is incorrect. Clinicians from LMIC view the absence of consideration of local resource limitations as the greatest obstacle for guideline implementation. The results regarding HF guidelines likely also have implications for other guidelines and resultant patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3485","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T11:40:11Z","timestamp":1729856411000},"page":"435-441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Applicability of Heart Failure Clinical Practice Guidelines in Low- and Middle-Income Countries"],"prefix":"10.1093","volume":"27","author":[{"given":"Shelley","family":"Zieroth","sequence":"first","affiliation":[{"name":"Section of Cardiology, Max Rady College of Medicine, University of Manitoba , Winnipeg, MB ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara In\u00e9s Saldarriaga","family":"Giraldo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Pontifical Bolivarian University and University of Antioquia , Medell\u00edn ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Pinto","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade de Lisboa, CCUL@RISE , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK) of German Heart Center Charit\u00e9, German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charit\u00e9 Universit\u00e4tsmedizin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, The Ohio State University College of Medicine , Columbus, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Atherton","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Brisbane and Women's Hospital and University of Queensland Faculty of Medicine , Brisbane, QLD ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute , Dallas, TX ,","place":["USA"]},{"name":"University of Mississippi , Jackson, MS ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Chopra","sequence":"additional","affiliation":[{"name":"Max Super Specialty Hospital , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.S.","family":"Coats","sequence":"additional","affiliation":[{"name":"Heart Research Institute , Sydney, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Dean","sequence":"additional","affiliation":[{"name":"Translational Medicine Academy , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Zamorano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Ram\u00f3n y Cajal; CIBERCV , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Peking Union Medical College , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Weiskopf","sequence":"additional","affiliation":[{"name":"Translational Medicine Academy , Basel ,","place":["Switzerland"]},{"name":"University of California , San Francisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Colardelle","sequence":"additional","affiliation":[{"name":"Translational Medicine Academy , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"2026010913023985000_ejhf3485-bib-0001","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1016\/S0140-6736(03)14546-1","article-title":"From best evidence to best practice: Effective implementation of change in patients' care","volume":"362","author":"Grol","year":"2003","journal-title":"Lancet"},{"key":"2026010913023985000_ejhf3485-bib-0002","first-page":"41","article-title":"Heart failure guidelines implementation: Lifting barriers using registries and networks","volume":"24","author":"Keramida","year":"2020","journal-title":"Anatol J Cardiol"},{"key":"2026010913023985000_ejhf3485-bib-0003","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13012-022-01223-6","article-title":"Trends in guideline implementation: An updated scoping review","volume":"17","author":"Peters","year":"2022","journal-title":"Implement Sci"},{"key":"2026010913023985000_ejhf3485-bib-0004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jchf.2022.08.009","article-title":"Heart failure drug treatment-inertia, titration, and discontinuation: A multinational observational study (EVOLUTION HF)","volume":"11","author":"Savarese","year":"2023","journal-title":"JACC Heart Fail"},{"key":"2026010913023985000_ejhf3485-bib-0005","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jclinepi.2022.02.015","article-title":"Methodological approaches for developing, reporting, and assessing evidence-based clinical practice guidelines: A systematic survey","volume":"146","author":"Yao","year":"2022","journal-title":"J Clin Epidemiol"},{"key":"2026010913023985000_ejhf3485-bib-0006","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: A comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"2026010913023985000_ejhf3485-bib-0007","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/j.jacc.2021.12.011","article-title":"2022 AHA\/ACC\/HFSA Guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026010913023985000_ejhf3485-bib-0008","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ejhf.2333","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by 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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