{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:06:14Z","timestamp":1779793574474,"version":"3.53.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Guideline\u2010directed medical therapy (GDMT) improves outcomes in heart failure with reduced ejection fraction, yet its adoption across Asia remains suboptimal. The American Heart Association launched the GWTG\u2010HF A.S.I.A. (Get With The Guidelines\u2010Heart Failure Adherence to Science, Implementation in Asia) program in 2021. We examined the association between program participation and GDMT implementation in Taiwan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed 1991 patients with heart failure with reduced ejection fraction enrolled in the Taiwan Society of Cardiology HF Registry (2021\u20132024). Four hospitals participated in the GWTG\u2010HF A.S.I.A. program (n=462) and 23 nonparticipating hospitals served as controls (n=1529). After propensity\u2010score matching, prescription trends of 4\u2010pillar GDMTs were compared using generalized estimating equations. Primary outcomes were patient\u2010level and hospital\u2010level GDMT prescription rates; secondary outcomes included echocardiographic remodeling, loss to follow\u2010up, and 2\u2010year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Between 2021 and 2024, GDMT use increased in both groups, with greater gains in participating hospitals. Adjusted odds ratios (aOR) for program participation were 2.73 (95% CI, 2.23\u20133.34) for 4\u2010pillar GDMTs, 1.59 (95% CI, 1.31\u20131.92) for angiotensin receptor\u2010neprilysin inhibitors, 2.06 (95% CI, 1.72\u20132.47) for SGLT2 (sodium\u2010glucose co\u2010transporter 2) inhibitors, and 1.63 (95% CI, 1.34\u20132.00) for mineralocorticoid receptor antagonists (all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). After SGLT2 inhibitor reimbursement in 2022, the prescription gap widened. Participating hospitals showed greater left\u2010ventricular reverse remodeling and lower loss\u2010to\u2010follow\u2010up (0.5% versus 5.2%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), and 2\u2010year mortality was similar.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Participation in the GWTG\u2010HF A.S.I.A. program was associated with higher GDMT prescription rates in Taiwanese hospitals. Structured quality improvement initiatives may help bridge the evidence\u2010practice gap in Asia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047097","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:14:40Z","timestamp":1766117680000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of the Get With The Guidelines\u2010Heart Failure Adherence to Science, Implementation in Asia (GWTG\u2010HF A.S.I.A.) Program in Taiwan"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1219-7739","authenticated-orcid":false,"given":"Hung\u2010Yu","family":"Chang","sequence":"first","affiliation":[{"name":"Cheng Hsin General Hospital","place":["Taipei, Taiwan"]},{"name":"National Yang Ming Chiao Tung University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Te","family":"Liao","sequence":"additional","affiliation":[{"name":"Chi\u2010Mei Medical Center","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7730-8490","authenticated-orcid":false,"given":"Paul A.","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-3095","authenticated-orcid":false,"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, CU Anschutz","place":["Aurora, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9441-1836","authenticated-orcid":false,"given":"Shih\u2010Hsien","family":"Sung","sequence":"additional","affiliation":[{"name":"Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University","place":["Taipei, Taiwan"]},{"name":"Taipei Veterans General Hospital","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2098-5922","authenticated-orcid":false,"given":"Wen\u2010Jone","family":"Chen","sequence":"additional","affiliation":[{"name":"Min\u2010Sheng General Hospital","place":["Tao\u2010Yuan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7180-3607","authenticated-orcid":false,"given":"Tzung\u2010Dau","family":"Wang","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital and National Taiwan University College of Medicine","place":["Taipei City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0390-2360","authenticated-orcid":false,"given":"Yi\u2010Heng","family":"Li","sequence":"additional","affiliation":[{"name":"National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9493-7325","authenticated-orcid":false,"given":"Chien\u2010Yi","family":"Hsu","sequence":"additional","affiliation":[{"name":"Taipei Medical University Hospital","place":["Taipei, Taiwan"]},{"name":"Taipei Medical 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