{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:18:17Z","timestamp":1747185497126,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:00:00Z","timestamp":1667865600000},"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":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Heart failure is a major burden in Australia in terms of morbidity, mortality and healthcare expenditure. Multiple evidence\u2010based therapies are recommended for heart failure with reduced ejection fraction (HFrEF), but data on physician adherence to therapy guidelines are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare use of HFrEF therapies against current evidence\u2010based guidelines in an Australian hospital inpatient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients admitted with a principal diagnosis of HFrEF across six metropolitan hospitals in Sydney, Australia, between January 2015 and June 2016. Use of medical and device therapies was compared with guideline recommendations using individual patient indications\/contraindications. Readmission and mortality data were collected for a 1\u2010year period following the admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1028 HFrEF patients identified, 39 were being managed with palliative intent, leaving 989 patients for the primary analysis. Use of beta\u2010blockers (87.7% actual use\/93.6% recommended use) and diuretics (88.4%\/99.3%) was high among eligible patients. There were large evidence\u2010practice gaps for angiotensin\u2010converting enzyme inhibitors\/angiotensin II receptor blockers (ACEI\/ARB; 66.4%\/89.0%) and aldosterone antagonists (41.0%\/77.1%). In absolute terms, use of these therapies each increased by over 11% from admission. Ivabradine (11.5%\/21.2%), automated internal cardiac defibrillators (29.5%\/66.1%) and cardiac resynchronisation therapy (13.1%\/28.7%) were used in a minority of eligible patients. Over the 1\u2010year follow\u2010up period, the mortality rate was 14.8%, and 44.2% of patients were readmitted to hospital at least once.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hospitalisation is a key mechanism for initiation of HFrEF therapies. The large evidence\u2010practice gaps for ACEI\/ARB and aldosterone antagonists represent potential avenues for improved HFrEF management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15830","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T16:24:42Z","timestamp":1654532682000},"page":"1595-1601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>Guideline\u2010based<\/scp> audit of the hospital management of heart failure with reduced ejection fraction"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6900-2029","authenticated-orcid":false,"given":"Douglas","family":"Drak","sequence":"first","affiliation":[{"name":"Sydney Medical School University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Fulcher","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Cardiology Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health, University of Sydney NHMRC Clinical Trials Centre  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Kilian","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bankstown\u2010Lidcombe Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James J. H.","family":"Chong","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Cardiology Westmead Hospital  Sydney New South Wales Australia"},{"name":"Centre for Heart Research Westmead Institute for Medical Research  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rominder","family":"Grover","sequence":"additional","affiliation":[{"name":"Sydney Local Health District Canterbury Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew P.","family":"Sindone","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Department of Cardiac Rehabilitation Concord Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Adams","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney  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