Frequency and Predictors of Virtual Visits in Patients With Heart Failure Within a Large Health System: Retrospective Cohort Study.

Background: Virtual care interventions have the potential to improve access to care and serial medication intensification for patients with chronic heart failure with reduced ejection fraction (HFrEF). However, concerns remain that these interventions might unintentionally create or widen existing disparities in care delivery and patient outcomes.

Objective: This study aimed to characterize the health care use patterns of patients who have HFrEF, including specialty type and frequency of in-person and virtual visits.

Trends in urine drug screening and positivity among patients with heart failure: Insights from a large health system.

Background: Substance use is common in patients with HF and affects candidacy for advanced HF therapies. Rates and results of urine drug screening (UDS) are understudied particularly in the setting of increasing decriminalization of some substances. Substance use, particularly cannabis, has been increasing in older age groups who are most at risk of HF.

Sodium-Glucose Cotransporter 2 Inhibitor Use for Heart Failure in US Ambulatory Cardiovascular Care.

Importance: Sodium-glucose cotransporter 2 inhibitor (SGLT2i) therapy reduces risk of heart failure (HF) events and cardiovascular death among individuals with HF. Trends of SGLT2i use in cardiovascular ambulatory care in the US remain unknown.

Objective: To evaluate the rate of SGLT2i use among patients with HF in the cardiovascular ambulatory care setting.

Responsiveness validity for measures of adjustment to life with a left ventricular assist device: Findings from the MCS A-QOL study.

Unlabelled: This report evaluated responsiveness validity (sensitivity to change) for five ventricular assist device (VAD)-specific patient-reported outcomes (PROs). Patients at 12 U.S.

Failure to Launch: Insights From Randomized Trials on Implementation Strategies for Guideline-Directed Therapies for Heart Failure.

There is a pressing need to translate evidence for heart failure (HF) therapies into contemporary practice. Medications that improve HF morbidity and mortality remain underused because of complex barriers at multiple levels across the health care ecosystem. High-quality implementation trials demonstrate that specific interventions can increase prescription, intensification, and persistence of HF medication.

Get With the Guidelines-Heart Failure: Twenty Years in Review, Lessons Learned, and the Road Ahead.

The Get With the Guidelines-Heart Failure program was developed in 2005 with the goal of bringing evidence-based guidelines in heart failure management into widespread clinical practice. The program includes workshops, webinars, tool kits, chart abstraction, performance benchmarking, and achievement awards to drive quality improvement at participating hospitals. Two decades after its inception, the program has grown to include over 600 participating institutions across the United States.

Risk-Based Primary Prevention of Heart Failure: A Scientific Statement From the American Heart Association.

The growing morbidity, mortality, and health care costs related to heart failure (HF) underscore the urgent need to prioritize its primary prevention. Whereas a risk-based approach for HF prevention remains in its infancy, several key opportunities exist to actualize this paradigm in clinical practice. First, the 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America HF guidelines provided recommendations, for the first time, on the clinical utility of multivariable risk equations to estimate risk of incident HF.

Review of the Global Activity of Heart Transplant.

Heart failure is a global disease with significant morbidity. Heart transplant (HT) can be a lifesaving therapy for select patients with end-stage heart failure. In 2020, over 7000 HTs were performed globally; 90% of HTs were performed in the United States and Western Europe, with only 10% throughout the rest of the world.

Patients' and Caregivers' Perspectives on the Role of Ambulatory Specialty Palliative Care for People With Heart Failure.

Context: Palliative care is a component of high-quality care for people with heart failure (HF). However, how best to deliver specialist palliative care (SPC) within ambulatory settings is unknown. Such information could help healthcare systems expand access to these services.

Multiregional Implementation Initiative's Impact on Guideline-Based Performance Measures for Patients Hospitalized With Heart Failure: IMPLEMENT-HF.

Background: Despite randomized data for survival benefit (with class 1 recommendations) for treating heart failure (HF) with reduced ejection fraction using quadruple medical therapy (QMT)-defined as evidence-based β-blockers, sodium-glucose cotransporter 2 inhibitor, preferably angiotensin receptor/neprilysin inhibitor, and mineralocorticoid receptor antagonist-it is underutilized. IMPLEMENT-HF is a multiregional HF quality improvement initiative to improve care and outcomes for patients with HF by enhancing the use of QMT in routine practice.

Methods: This analysis of HF with reduced ejection fraction treatment in patients from hospitals participating in the American Heart Association's Get With The Guidelines-HF who volunteered to participate in IMPLEMENT-HF in 7 US regions.

Challenges Related to Out-of-Pocket Costs in Heart Failure Management.

High out-of-pocket costs and financial toxicity related to heart failure treatment are substantial concerns. Two of 4 pillars of guideline-directed medical therapy for heart failure with reduced ejection fraction, for example, carry high costs that may attenuate their uptake. Furthermore, heart failure rarely occurs in isolation.

Clinical Considerations for Competitive Sports Participation for Athletes With Cardiovascular Abnormalities: A Scientific Statement From the American Heart Association and American College of Cardiology.

This American Heart Association/American College of Cardiology scientific statement on clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities or diseases is organized into 11 distinct sections focused on sports-specific topics or disease processes that are relevant when considering the potential risks of adverse cardiovascular events, including sudden cardiac arrest, during competitive sports participation. Task forces comprising international experts in sports cardiology and the respective topics covered were assigned to each section and prepared specific clinical considerations tables for practitioners to reference. Comprehensive literature review and an emphasis on shared decision-making were integral in the writing of all clinical considerations presented.

Health Literacy in Heart Failure: A Review of the Gaps and Challenges.

Health literacy has an essential role in heart failure (HF), contributing to medication adherence, disease self-management, and interactions with care providers. Yet, data on interventions to enhance health literacy are scarce. HF guidelines identify health literacy as an individual-level barrier to HF management but offer limited guidance on addressing limited health literacy.

Recognition of the Large Ambulatory C2D Stage of Advanced Heart Failure-A Call to Action.

Importance: The advanced ambulatory heart failure (HF) population comprises patients who have progressed beyond the pillars of recommended stage C HF therapies but can still find meaningful life-years ahead. Although these patients are commonly encountered in practice, national databases selectively capture the small groups accepted for heart transplant listing or left ventricular assist devices. The epidemiology, trajectories, and therapies for other ambulatory patients with advanced HF are poorly understood.

Contributors and Solutions to High Out-of-Pocket Costs for Heart Failure Medications: A State-of-the-Art Review.

As expensive therapeutics rise to the fore of heart failure management, out-of-pocket (OOP) medication costs have become increasingly relevant to patient care. Prescription medication costs influence medical decision-making and affect adherence. Yet, individualized cost estimates are seldom available during clinical encounters when prescription decisions are made.

The Colorado Heart Failure Acuity Risk Model: A Mortality Model for Waitlisted Cardiac Transplant Patients.

Background: Currently, there is no mathematical model used nationally to determine the medical urgency of patients on the heart transplant waitlist in the United States. While the current organ distribution system accounts for many patient factors, a truly objective model is needed to more reliably stratify patients by their medical acuity.

Objectives: The aim of the study was to develop risk scores (Colorado Heart failure Acuity Risk Model [CHARM] score) to predict mortality in adults waitlisted for heart transplant.

Stroke-bleeding risk score pairings within individuals in the outcomes registry for better informed treatment of atrial fibrillation (ORBIT-AF) registry.

Background: Decisions about stroke prevention strategies in atrial fibrillation (AF) typically balance thromboembolism reduction against increased bleeding from oral anticoagulation therapy (OAC). When determining eligibility for OAC, guidelines recommend calculation of thromboembolic event rates using a validated score such as CHA2DS2-VASc. In contrast, routine calculation of bleeding scores is not recommended, in part because many patient factors associated with an increased risk of bleeding are associated with an even larger increased risk of ischemic stroke.

Guideline-Directed Medical Therapy After Hospitalization for Acute Heart Failure: Insights From the CONNECT-HF.

Background: Significant gap remains in the implementation of guideline-directed medical therapy (GDMT) in patients with heart failure after a hospitalization. We aimed to evaluate the use and titration of GDMT at discharge and over a 12-month period after hospital discharge and to identify factors associated with GDMT use and titration.

Methods And Results: The CONNECT-HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) trial evaluated the effect of a hospital and postdischarge quality improvement intervention in participants with heart failure with reduced ejection fraction.

Integrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction: A Stepped-Wedge Trial (POCKET-COST-HF).

Background: Guideline-directed medical therapy for heart failure (HF) with reduced ejection fraction can entail high out-of-pocket (OOP) costs, prompting concerns about financial toxicity and access. OOP costs are generally unavailable during encounters. This trial assessed the impact of providing patient-specific OOP costs to patients and clinicians.

Personalized Patient Data and Behavioral Nudges to Improve Adherence to Chronic Cardiovascular Medications: A Randomized Pragmatic Trial.

Importance: Poor medication adherence is common. Text messaging is increasingly used to change patient behavior but often not rigorously tested.

Objective: To compare different types of text messaging strategies with usual care to improve medication refill adherence among patients nonadherent to cardiovascular medications.

Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America.

Heart failure (HF) is characterized by significant symptoms, compromised quality of life, frequent hospital admissions, and high mortality rates; palliative care (PC) is, therefore, highly relevant for patients with HF and their clinicians. Multiple guidelines and consensus statements recommend the provision of PC alongside HF management. However, few resources exist to guide the integration of PC into HF care, for both primary PC (provided by HF clinicians in the course of HF care) and specialty PC (provided by PC specialists).

Hospital Heart Failure Medical Therapy Score and Associated Clinical Outcomes and Costs.

Importance: A composite score for guideline-directed medical therapy (GDMT) for patients with heart failure (HF) is associated with increased survival. Whether hospital performance according to a GDMT score is associated with a broader array of clinical outcomes at lower costs is unknown.

Objectives: To evaluate hospital variability in GDMT score at discharge, 90-day risk-standardized clinical outcomes and costs, and associations between hospital GDMT score and clinical outcomes and costs.