Large-Scale Initiative Enhances Use of Proven Heart Failure Medications

A comprehensive effort to improve heart failure treatment across hospitals in the United States has shown significant progress in adopting lifesaving medications. The American Heart Association launched the multiregional IMPLEMENT-HF initiative in 2021, aiming to increase the use of evidence-based therapies among patients hospitalized with heart failure with reduced ejection fraction (HFrEF). The initiative's focus was on promoting quadruple medical therapy, which includes angiotensin receptor–neprilysin inhibitors (ARNI), specific beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors—drugs proven to lower mortality rates in heart failure patients.

Analyzing data from over 43,000 patients across 67 hospitals, the study revealed that the use of all four recommended drug classes increased dramatically from 4.7% to 44.6% at hospital discharge and from 0% to 44.8% within 30 days post-discharge among participating hospitals. This improvement was consistent regardless of race, ethnicity, or gender, highlighting a move towards more equitable care. Additionally, hospitals enhanced their assessments of patients' social needs, contributing to more personalized and comprehensive treatment.

The initiative was built on the Get With The Guidelines—Heart Failure program and fostered a collaborative learning environment where hospitals shared best practices and monitored performance to close care gaps. Experts emphasized that this approach is a major step forward in reducing the treatment gap in heart failure management, which is crucial given that nearly half of patients hospitalized for heart failure have HFrEF, a condition with a five-year mortality rate of about 75%. Although clinical trials have demonstrated the survival benefits of quadruple therapy, its widespread adoption has been limited, especially among underserved populations.

By supporting data-driven improvement efforts, the IMPLEMENT-HF initiative exemplifies the power of collaboration in transforming heart failure care, aiming to ensure all patients receive the highest standard of treatment regardless of their location or background.