Impact of Multidisciplinary Interventions on the Enhancement of Guideline-Directed Medical Therapy and Clinical Education in Hospitalized Heart Failure Patients.

Abstract

Although the efficacy of quadruple therapy-including angiotensin receptor neprilysin inhibitor-in patients with heart failure is well established, the impact of multidisciplinary interventions on its implementation in real-world clinical practice remains unclear.We retrospectively included 90 patients who received multidisciplinary intervention between April 2023 and March 2024 and 94 patients who received conventional care between April 2020 and March 2021. In the multidisciplinary care group, a standardized heart failure checklist was used to confirm the optimization of heart failure treatment. The rates of nutritional counseling, medication education, and rehabilitation introduction, as well as the implementation rate of quadruple therapy during hospitalization for heart failure, were compared between the groups.The mean age of patients was 75.7 years; 58.6% were male, and 45.3% had their first heart failure hospitalization. Background characteristics were not significantly different between the groups. The implementation rates for nutritional instruction, medication instruction, and rehabilitation were 51.2%, 72.0%, and 88.9% in the multidisciplinary intervention group, which were significantly higher than those in the conventional care group (26.3%, 49.5%, and 54.3%, respectively) (all P < 0.001). The rate of quadruple therapy implementation was higher (74.4%) compared to the conventional care group (30.6%) among the individuals with reduced ejection fraction (P < 0.001).In carefully-selected hospitalized patients with heart failure, multidisciplinary intervention was associated with increased utilization of evidence-based therapies, including quadruple therapy, highlighting its potential to enhance the quality of care in real-world clinical settings.