{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:06:14Z","timestamp":1785459974839,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"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":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Heart failure (HF) is increasingly prevalent, with growing patient complexity. Understanding the quality of care delivered is key to optimising management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To characterise HF care by a general medicine service compared to established quality indicators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort review was conducted over a 7\u2010month period. Consecutive general medicine patients admitted with a primary diagnosis of HF were included. Main outcomes measures were baseline guideline\u2010directed medical therapy (GDMT) and index admission medication modifications, planned medical follow\u2010up and 30\u2010 and 180\u2010day readmission rates. Comparison to National Heart Foundation quality indicators was undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and thirteen patients who survived the index admission were included (median age 86\u2009years (interquartile range 82\u201089), 53.1% female). Comorbidities included hypertension (69.0%), atrial fibrillation (58.7%) and chronic kidney disease (28.2%). Echocardiography was available for 153 patients (72%), with 26.6% who had HF with reduced ejection fraction (HFrEF) and 62.2% who had HF with preserved ejection fraction (HFpEF). GDMT for HFrEF was 73.2% for beta\u2010blockers, 41.5% for renin\u2010angiotensin system inhibitors, 22.0% for mineralocorticoid antagonists and 9.8% for sodium glucose co\u2010transporter\u20102 inhibitors (SGLT2i). SGLT2i was prescribed in 2.1% of HFpEF patients. Index admission medication modifications occurred for 40 patients, with 37 initiation\/dose escalations and 13 cessation\/dose de\u2010escalations. Follow\u2010up was planned in 69.0% patients across multiple services. All\u2010cause readmission rates at 30 and 180 days were 19.2% and 45.5% respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our HF cohort is elderly and comorbid with high readmission rates. We found low prescription and modification rates of GDMT and poor continuity of care, highlighting areas to improve care in both inpatient and outpatient settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.70016","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T16:55:06Z","timestamp":1741625706000},"page":"795-802","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Performance and opportunity: retrospective cohort study of general medicine heart failure management"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6993-764X","authenticated-orcid":false,"given":"Noor","family":"Lammoza","sequence":"first","affiliation":[{"name":"Department of General Medicine Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9178-1057","authenticated-orcid":false,"given":"Lung En","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of General Medicine Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Edwards","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Hormiz","sequence":"additional","affiliation":[{"name":"Department of General Medicine Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Morton","sequence":"additional","affiliation":[{"name":"Department of General Medicine Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Department of General Medicine Alfred Health  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8805-370X","authenticated-orcid":false,"given":"Ingrid","family":"Hopper","sequence":"additional","affiliation":[{"name":"Department of General Medicine Alfred Health  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3317-945X","authenticated-orcid":false,"given":"Ar Kar","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of General Medicine Alfred Health  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Thayaparan","sequence":"additional","affiliation":[{"name":"Department of General Medicine Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1748-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-016-0208-4"},{"key":"e_1_2_7_4_1","unstructured":"The Heart Failure Toolkit I The Heart Foundation (Internet).heartfoundation\u2010prod.azurewebsites.net. [cited 2024 Jun 1]. Available from URL:https:\/\/www.heartfoundation.org.au\/bundles\/for-professionals\/the-heart-failure-toolkit"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2018.06.1042"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107038"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.00801"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13647"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23664"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.067489"},{"key":"e_1_2_7_14_1","article-title":"A missed therapeutic opportunity? SGLT\u20102 inhibitor use in general medicine patients with heart failure: a retrospective audit of admissions to a tertiary health service","volume":"1","author":"Perera P","year":"2022","journal-title":"Clinical Med Insights Cardiol"},{"key":"e_1_2_7_15_1","unstructured":"Health.Expanded Access to Chronic Heart Failure Treatment on the PBS (Internet). Australian Government Department of Health and Aged Care.2023[cited 2024 Mar 23]. Available from URL:https:\/\/www.health.gov.au\/ministers\/the-hon-mark-butler-mp\/media\/expanded-access-to-chronic-heart-failure-treatment-on-the-pbs"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2020.08.017"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52026"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12405"},{"key":"e_1_2_7_19_1","unstructured":"Partnered Pharmacist Medication Charting (PPMC) Scaling Project | Safer Care Victoria (Internet).2020. Available from URL:https:\/\/www.safercare.vic.gov.au\/best-practice-improvement\/improvement-projects\/medications-treatment-infection-prevention\/ppmc"},{"key":"e_1_2_7_20_1","first-page":"10","article-title":"Impact of a heart failure multidisciplinary clinic on the reduction of healthcare\u2010related events and costs: the GEstIC study","volume":"29","author":"Rego R","year":"2023","journal-title":"Front Cardiovascular Med"},{"key":"e_1_2_7_21_1","unstructured":"MebazaaA DavisonB ChioncelO Cohen\u2010SolalA DiazR FilippatosGet al.Safety tolerability and efficacy of up\u2010titration of guideline\u2010directed medical therapies for acute heart failure (STRONG\u2010HF): a multinational open\u2010label randomised trial. [cited 2023 Jun 3]. Available from URL:https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(22)02076-1\/fulltext."}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T16:05:25Z","timestamp":1747238725000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/imj.70016"],"URL":"https:\/\/doi.org\/10.1111\/imj.70016","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]},"assertion":[{"value":"2024-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}