{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:36Z","timestamp":1789715016927,"version":"4.0.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Guideline\u2010directed medical therapy during the transitional period is crucial for improving outcomes in heart failure with reduced ejection fraction. We investigated whether a simplified transitional care intervention could increase guideline\u2010directed medical therapy adherence in patients with acute heart failure (HF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This multicenter, open\u2010label randomized trial enrolled 982 patients with acute HF. The transitional care intervention included a discharge checklist, HF education, and telephone monitoring. The primary outcome was achievement of high guideline adherence indicator, defined as the prescription of all 3 guideline\u2010directed medical therapy drugs (renin\u2010angiotensin system blockades, beta blockers, and mineralocorticoid receptor antagonists) at 6\u2009months. Both modified intention\u2010to\u2010treat and per\u2010intervention analyses were conducted to evaluate the effectiveness of intervention components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 982 participants (mean age, 62.4\u00b115.5\u2009years; 64.5% male), there was no statistical difference in the proportion achieving a high guideline adherence indicator between the intervention and control groups (49.6% versus 44.6%; OR, 1.12; 95% CI, 0.86\u20131.45;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.37). No significant differences were observed in the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score or clinical outcomes. In the per\u2010intervention analysis, patients who received all components showed significantly higher guideline adherence indicator achievement compared with those who received no components (adjusted odds ratio [OR], 1.56 [95% CI, 1.07\u20132.27],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this randomized trial of patients with acute HF, although the simplified transitional care intervention did not increase high guideline adherence indicator achievement, implementation of all intervention components was associated with improved guideline adherence. Our findings emphasize that implementation fidelity is the key challenge in optimizing transitional care for HF management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT04900584.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044747","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:09:41Z","timestamp":1778058581000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of an Intervention to Improve Guideline\u2010Directed Medications for Patients With Acute Heart Failure: A Randomized Clinical Trial"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1790-3228","authenticated-orcid":false,"given":"Jung\u2010Woo","family":"Son","sequence":"first","affiliation":[{"name":"Yonsei University, Wonju College of Medicine","place":["Wonju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8480-9082","authenticated-orcid":false,"given":"Dong\u2010Hyuk","family":"Cho","sequence":"additional","affiliation":[{"name":"Korea University Anam Hospital","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9824-1069","authenticated-orcid":false,"given":"Se\u2010Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University, Wonju College of Medicine","place":["Wonju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2834-2718","authenticated-orcid":false,"given":"Jimi","family":"Choi","sequence":"additional","affiliation":[{"name":"Korea University Anam Hospital","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0146-2189","authenticated-orcid":false,"given":"Dong\u2010Ju","family":"Choi","sequence":"additional","affiliation":[{"name":"Seoul National University Bundang Hospital","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun\u2010Jai","family":"Cho","sequence":"additional","affiliation":[{"name":"Seoul National University Hospital","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8756-409X","authenticated-orcid":false,"given":"Chan Joo","family":"Lee","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2441-2267","authenticated-orcid":false,"given":"Jin Oh","family":"Choi","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7290-2463","authenticated-orcid":false,"given":"Sang Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Asan Medical Center, University of Ulsan College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eung Ju","family":"Kim","sequence":"additional","affiliation":[{"name":"Korea University Guro Hospital","place":["Seoul, Republic of 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