Initiation, Adherence, and Persistence to Guideline-Directed Medical Therapy After Heart Failure Hospitalization: Bridging the Gap Between Prescription and Sustained Use

Highlights

• Despite increased prescription of guideline-directed medical therapy (GDMT) at discharge, primary nonadherence rates remain high across β-blockers, RAS inhibitors, MRAs, and SGLT2 inhibitors.
• Early initiation and persistent use of quadruple therapy in heart failure with reduced ejection fraction (HFrEF) patients correlates with improved left ventricular ejection fraction and reduced adverse events.
• Real-world data reveal suboptimal dose titration and frequent discontinuations, highlighting the need for interventions beyond initial discharge prescriptions.
• Frailty and other patient factors influence GDMT use, underscoring the necessity for personalized approaches to optimize therapy adherence and persistence.

Background