JAMA Cardiology Author Interviews Heart Failure Medical Therapy Score and Clinical Outcomes
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Sep 25, 2024 Paul L. Hess, MD, MHS, and Vincenzo B. Polsinelli, MD, delve into heart failure treatment protocols and their real-world implications. They discuss the importance of the Guideline-Directed Medical Therapy (GDMT) score, emphasizing its role in enhancing patient outcomes. The variability in treatment effectiveness across hospitals is scrutinized, revealing stark differences in mortality and rehospitalization rates. The duo advocates for stronger adherence to hospital-level guidelines as a means to improve care quality and reduce healthcare costs.
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Hospital GDMT Use Varies Widely
- Hospitals vary widely in heart failure guideline-directed medical therapy (GDMT) use and outcomes like mortality and rehospitalization.
- Improving GDMT at hospital level is key to enhancing value, defined as outcomes relative to cost.
Focus on GDMT Medication Classes
- Use an opportunity-based GDMT score reflecting medication classes given at discharge, not doses.
- Focus on medication initiation as a primary quality measure post-heart failure hospitalization.
Large Variability in GDMT and Outcomes
- GDMT hospital scores range widely from 0.39 to 0.94, showing large variability across 360 hospitals.
- Outcomes including mortality, rehospitalization, home time, and costs also vary significantly across hospitals.