Skip to main content
Log in

The treatment gap in patients with chronic systolic heart failure: a systematic review of evidence-based prescribing in practice

Heart Failure Reviews Aims and scope Submit manuscript

Abstract

The extent and impact of under-prescribing of evidence-based pharmacological therapies among heart failure patients with reduced ejection fraction (HFREF) in contemporary practice is unclear. We sought to examine the prescribing patterns of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), β-blockers (BBs) and mineralocorticoid receptor antagonists (MRAs), and to quantify the estimated ‘treatment gap’ among HFREF patients in the ‘real-world’ setting. The MEDLINE, PubMed, EMBASE, CINAHL and CENTRAL databases were searched for registry- or survey-based studies which examined the prescribing rates of ACE inhibitors, ARBs, BBs and MRAs among HFREF patients. Searches were limited to those published in the years 2000–2015. A total of 23 reports, including 83,605 patients, were evaluated. Overall, ACE inhibitors/ARBs, BBs and MRAs were prescribed to 79.8, 81.4 and 36.4 % of patients, respectively. The estimated treatment gaps in the overall population were 13.1 % for ACE inhibitors/ARBs, 3.9 % for BBs and 16.8 % for MRAs. The proportion of patients who received ≥50 % of the guideline-recommended target doses was 72 % for ACE inhibitors, 51 % for ARBs, 49 % for BBs, 53 % for the combination of ACE inhibitors/ARBs and BBs and 83 % for MRAs. Prescribing these drugs according to contemporary guidelines was associated with lower mortality risk. Patients who were elderly, female and with comorbidities were less likely to receive optimal treatment as recommended by the guidelines. ACE inhibitors, ARBs, BBs and MRAs are under-prescribed in eligible HFREF patients. Efforts should be made to improve approaches to closing the treatment gap at both systems of care and individual levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Krum H, Abraham WT (2009) Heart failure. Lancet 373:941–955

    Article  PubMed  Google Scholar 

  2. McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip GYH, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A (2012) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 33:1787–1847

    Article  PubMed  Google Scholar 

  3. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey J, Donald E, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJV, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WHW, Tsai EJ, Wilkoff BL (2013) 2013 ACCF/AHA Guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 128:e240–e327

    Article  PubMed  Google Scholar 

  4. Komajda M, Lapuerta P, Hermans N, Gonzalez-Juanatey JR, van Veldhuisen DJ, Erdmann E, Tavazzi L, Poole-Wilson P, Le Pen C (2005) Adherence to guidelines is a predictor of outcome in chronic heart failure: the MAHLER survey. Eur Heart J 26(16):1653–1659. doi:10.1093/eurheartj/ehi251

    Article  PubMed  Google Scholar 

  5. Poelzl G, Altenberger J, Pacher R, Ebner CH, Wieser M, Winter A, Fruhwald F, Dornaus C, Ehmsen U, Reiter S, Steinacher R, Huelsmann M, Eder V, Boehmer A, Pilgersdorfer L, Ablasser K, Keroe D, Groebner H, Auer J, Jakl G, Hallas A, Ess M, Ulmer H (2014) Dose matters! Optimisation of guideline adherence is associated with lower mortality in stable patients with chronic heart failure. Int J Cardiol 175(1):83–89. doi:10.1016/j.ijcard.2014.04.255

    Article  PubMed  Google Scholar 

  6. Komajda M (2009) How well are we implementing evidence-based care? Eur J Heart Failure Suppl 8:i39–i44

    Article  Google Scholar 

  7. Teng T-HK, Hung J, Knuiman M, Stewart S, Arnolda L, Jacobs I, Hobbs M, Sanfilippo F, Geelhoed E, Finn J (2012) Trends in long-term cardiovascular mortality and morbidity in men and women with heart failure of ischemic versus non-ischemic aetiology in Western Australia between 1990 and 2005. Int J Cardiol 158:405–410

    Article  PubMed  Google Scholar 

  8. Lainščak M, Cleland JG, Lenzen MJ, Follath F, Komajda M, Swedberg K (2007) International variations in the treatment and co-morbidity of left ventricular systolic dysfunction: data from the EuroHeart Failure Survey. Eur J Heart Fail 9(3):292–299

    Article  PubMed  Google Scholar 

  9. Yancy CW, Fonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN (2009) Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: findings from IMPROVE HF. Am Heart J 157(4):754–762e752

    Article  PubMed  Google Scholar 

  10. The Study Group on Diagnosis of the Working Group on Heart Failure of The European Society of Cardiology (1999) Increasing awareness and improving the management of heart failure in Europe: the IMPROVEMENT of HF initiative. Eur J Heart Fail 1:139–144

    Article  Google Scholar 

  11. Forman DE, Cannon CP, Hernandez AF, Liang L, Yancy C, Fonarow GC (2009) Influence of age on the management of heart failure: findings from Get With the Guidelines-Heart Failure (GWTG-HF). Am Heart J 157(6):1010–1017

    Article  PubMed  Google Scholar 

  12. Fonarow GC, Abraham WT, Albert NM, Gattis WA, Gheorghiade M, Greenberg B, O’Connor CM, Yancy CW, Young J (2004) Organized program to initiate lifesaving treatment in hospitalized patients with heart failure (OPTIMIZE-HF): rationale and design. Am Heart J 148:43–51

    Article  PubMed  Google Scholar 

  13. Sharma A, Ezekowitz JA (2013) Similarities and differences in patient characteristics between heart failure registries versus clinical trials. Curr Heart Fail Rep 10(4):373–379. doi:10.1007/s11897-013-0152-x

    Article  PubMed  Google Scholar 

  14. Reid CM (2015) The role of clinical registries in monitoring drug safety and efficacy. Heart Lung Circ 24:1049–1052

    Article  PubMed  Google Scholar 

  15. Moher D, Liberati A, Tetzlaff J, Altman DG, and the PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Ann Intern Med 151:264–269

    Article  Google Scholar 

  16. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA Statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151:W-65–W-94

    Article  Google Scholar 

  17. Störk S, Hense HW, Zentgraf C, Uebelacker I, Jahns R, Ertl G, Angermann CE (2008) Pharmacotherapy according to treatment guidelines is associated with lower mortality in a community-based sample of patients with chronic heart failure: a prospective cohort study. Eur J Heart Fail 10:1236–1245

    Article  PubMed  Google Scholar 

  18. Kim SY, Park JE, Lee YJ, Seo H-J, Sheen S-S, Hahn S, Jang B-H, Son H-J (2013) Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity. J Clin Epidemiol 66:408–414

    Article  PubMed  Google Scholar 

  19. Ziff OJ, Lane DA, Samra M, Griffith M, Kirchhof P, Lip GYH, Steeds RP, Townend J, Kotecha D (2015) Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data. BMJ 351:h4451

    Article  PubMed  PubMed Central  Google Scholar 

  20. Song HJ, Son H, Seo H-J, Lee H, Choi SM, Lee S (2015) Effect of self-administered foot reflexology for symptom management in healthy persons: a systematic review and meta-analysis. Complement Ther Med 23:79–89

    Article  PubMed  Google Scholar 

  21. William JF, Bristow MR, Fowler MB, Francis GS, Garson A Jr, Gersh BJ, Hammer DF, Hlatky MA, Leier CV, Packer M, Pitt B, Ullyot DJ, Wexler LF, Winters WL (1995) Guidelines for the evaluation and management of heart failure. J Am Coll Cardiol 26:1376–1398

    Article  Google Scholar 

  22. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, Ganiats TG, Goldstein S, Gregatos G, Jessup ML, Noble RJ, Packer M, Silver MA, Stevenson LW (2001) ACC/AHA Guidelines for the evaluation and management of chronic heart failure in the adult—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee to revise the 1995 guidelines for the evaluation and management of heart failure). Circulation 104:2996–3007

    Article  CAS  PubMed  Google Scholar 

  23. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam M, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW (2005) ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 46(6):e1–82

    Article  PubMed  Google Scholar 

  24. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam M, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW (2009) 2009 Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 119:e391–e479

    Article  PubMed  Google Scholar 

  25. Task Force for the Diagnosis and Treatment of Chronic Heart Failure ESoC (2001) Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J 22:1527–1560

    Article  Google Scholar 

  26. Swedberg K, Cleland J, Dargie H, Drexler H, Follath F, Komajda M, Tavazzi L, Smiseth OA, Gavazzi A, Haverich A, Hoes A, Jaarsma T, Korewicki J, Lévy S, Linde C, Lopez-Sendon J-L, Nieminen MS, Piérard L, Remme WJ (2005) Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): the Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 26:1115–1140

    Article  PubMed  Google Scholar 

  27. Dickstein K, Cohen Solal A, Filippatos G, McMurray JJV, Ponikowski P, Poole-Wilson PA, Strömberg A, van Veldhuisen DJ, Atar D, Hoes AW, Keren A, Mebazaa A, Nieminen M, Priori SG, Swedberg K (2008) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 29:2388–2442

    Article  CAS  PubMed  Google Scholar 

  28. Heywood JT, Fonarow GC, Yancy CW, Albert NM, Curtis AB, Gheorghiade M, Inge PJ, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN (2010) Comparison of medical therapy dosing in outpatients cared for in cardiology practices with heart failure and reduced ejection fraction with and without device therapy: report from IMPROVE HF. Circ Heart Fail 3(5):596–605. doi:10.1161/circheartfailure.109.912683

    Article  PubMed  Google Scholar 

  29. McKee SP, Leslie SJ, LeMaitre JP, Webb DJ, Denvir MA (2003) Management of chronic heart failure due to systolic left ventricular dysfunction by cardiologist and non-cardiologist physicians. Eur J Heart Fail 5(4):549–555

    Article  PubMed  Google Scholar 

  30. Lenzen MJ, Boersma E, Scholte op Reimer WJM, Balk AHMM, Komajda M, Swedberg K, Follath F, Jimenez-Navarro M, Simoons ML, Cleland JGF (2005) Under-utilization of evidence-based drug treatment in patients with heart failure is only partially explained by dissimilarity to patients enrolled in landmark trials: a report from the Euro Heart Survey on Heart Failure. Eur Heart J 26:2706–2713

    Article  CAS  PubMed  Google Scholar 

  31. Anguita M, Comin-Colet J, Formiga F, Almenar L, Crespo-Leiro M, Manzano L, on behalf of the investigators of the VIDA–IC Study (2014) Current situation of management of systolic heart failure in Spain: VIDA–IC Study results. Rev Esp Cardiol 67(9):769–770

    Article  PubMed  Google Scholar 

  32. Cohen Solal A, Leurs I, Assyag P, Beauvais F, Clerson P, Contre C, Thebaut J-F, Genoun M, in collaboration with the French National College of Cardiologists (2012) Optimization of heart FailUre medical Treatment after hospital discharge according to left ventricUlaR Ejection fraction: the FUTURE survey. Arch Cardiovasc Dis 105(6–7):355–365. doi:10.1016/j.acvd.2012.04.003

    Article  PubMed  Google Scholar 

  33. de Groote P, Isnard R, Assyag P, Clerson P, Ducardonnet A, Galinier M, Jondeau G, Leurs I, Thebaut JF, Komajda M (2007) Is the gap between guidelines and clinical practice in heart failure treatment being filled? Insights from the IMPACT RECO survey. Eur J Heart Fail 9(12):1205–1211. doi:10.1016/j.ejheart.2007.09.008

    Article  PubMed  Google Scholar 

  34. de Groote P, Isnard R, Clerson P, Jondeau G, Galinier M, Assyag P, Demil N, Ducardonnet A, Thebaut JF, Komajda M (2009) Improvement in the management of chronic heart failure since the publication of the updated guidelines of the European Society of Cardiology. The Impact-Reco Programme. Eur J Heart Fail 11(1):85–91. doi:10.1093/eurjhf/hfn005

    Article  PubMed  Google Scholar 

  35. Fonarow GC, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN (2008) Heart failure care in the outpatient cardiology practice setting: findings from IMPROVE HF. Circ Heart Fail 1(2):98–106

    Article  PubMed  Google Scholar 

  36. Franke J, Zugck C, Wolter JS, Frankenstein L, Hochadel M, Ehlermann P, Winkler R, Nelles M, Zahn R, Katus HA, Senges J (2012) A decade of developments in chronic heart failure treatment: a comparison of therapy and outcome in a secondary and tertiary hospital setting. Clin Res Cardiol 101(1):1–10. doi:10.1007/s00392-011-0348-6

    Article  PubMed  Google Scholar 

  37. Frankenstein L, Remppis A, Fluegel A, Doesch A, Katus HA, Senges J, Zugck C (2010) The association between long-term longitudinal trends in guideline adherence and mortality in relation to age and sex. Eur J Heart Fail 12(6):574–580. doi:10.1093/eurjhf/hfq047

    Article  PubMed  Google Scholar 

  38. Goldberg RJ, Gurwitz JH, Saczynski JS, Hsu G, McManus DD, Magid DJ, Smith DH, Go AS (2013) Comparison of medication practices in patients with heart failure and preserved versus those with reduced ejection fraction (from the Cardiovascular Research Network [CVRN]). Am J Cardiol 111(9):1324–1329. doi:10.1016/j.amjcard.2013.01.276

    Article  PubMed  PubMed Central  Google Scholar 

  39. Hebert K, Dias A, Delgado MC, Franco E, Tamariz L, Steen D, Trahan P, Major B, Arcement LM (2010) Epidemiology and survival of the five stages of chronic kidney disease in a systolic heart failure population. Eur J Heart Fail 12(8):861–865. doi:10.1093/eurjhf/hfq077

    Article  PubMed  Google Scholar 

  40. Heywood JT, Fonarow GC, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, McBride ML, Mehra MR, O’Connor CM, Reynolds D, Walsh MN (2010) Influence of renal function on the use of guideline-recommended therapies for patients with heart failure. Am J Cardiol 105(8):1140–1146. doi:10.1016/j.amjcard.2009.12.016

    Article  PubMed  Google Scholar 

  41. Lenzen MJ, Rosengren A, Scholte op Reimer WJ, Follath F, Boersma E, Simoons ML, Cleland JG, Komajda M (2008) Management of patients with heart failure in clinical practice: differences between men and women. Heart (British Cardiac Society) 94(3):e10. doi:10.1136/hrt.2006.099523

    Article  CAS  Google Scholar 

  42. Lenzen MJ, Scholte op Reimer WJ, Boersma E, Vantrimpont PJ, Follath F, Swedberg K, Cleland J, Komajda M (2004) Differences between patients with a preserved and a depressed left ventricular function: a report from the EuroHeart Failure Survey. Eur Heart J 25(14):1214–1220. doi:10.1016/j.ehj.2004.06.006

    Article  CAS  PubMed  Google Scholar 

  43. Loh JC, Creaser J, Rourke DA, Livingston N, Harrison TK, Vandenbogaart E, Moriguchi J, Hamilton MA, Tseng CH, Fonarow GC, Horwich TB (2013) Temporal trends in treatment and outcomes for advanced heart failure with reduced ejection fraction from 1993–2010: findings from a university referral center. Circ Heart Fail 6(3):411–419

    Article  PubMed  PubMed Central  Google Scholar 

  44. Schneider PM, Pellegrini CN, Wang Y, Fein AS, Reynolds MR, Curtis JP, Masoudi FA, Varosy PD (2014) Prevalence of guideline-directed medical therapy among patients receiving cardiac resynchronization therapy defibrillator implantation in the National Cardiovascular Data Registry during the years 2006 to 2008. Am J Cardiol 113(12):2052–2056. doi:10.1016/j.amjcard.2014.03.049

    Article  PubMed  PubMed Central  Google Scholar 

  45. Scrutinio D, Passantino A, Santoro D, Catanzaro R (2011) The cardiorenal anaemia syndrome in systolic heart failure: prevalence, clinical correlates, and long-term survival. Eur J Heart Fail 13(1):61–67. doi:10.1093/eurjhf/hfq167

    Article  PubMed  Google Scholar 

  46. Shah DD, Fonarow GC, Horwich TB (2010) Metformin therapy and outcomes in patients with advanced systolic heart failure and diabetes. J Cardiac Fail 16(3):200–206. doi:10.1016/j.cardfail.2009.10.022

    Article  CAS  Google Scholar 

  47. Stålhammar J, Stern L, Linder R, Sherman S, Parikh R, Ariely R, Wikström G (2012) Resource utilization and cost of heart failure associated with reduced ejection fraction in Swedish patients. J Med Econ 15(5):938–946

    Article  PubMed  Google Scholar 

  48. von Scheidt W, Zugck C, Pauschinger M, Hambrecht R, Bruder O, Hartmann A, Rauchhaus M, Zahn R, Brachmann J, Tebbe U, Neumann T, Strasser RH, Bohm M, Stork S, Hochadel M, Heidemann P, Senges J (2014) Characteristics, management modalities and outcome in chronic systolic heart failure patients treated in tertiary care centers: results from the EVIdence based TreAtment in Heart Failure (EVITA-HF) registry. Clin Res Cardiol 103(12):1006–1014

    Article  Google Scholar 

  49. Cleland JG, Cohen-Solal A, Aguilar JC, Dietz R, Eastaugh J, Follath F, Freemantle N, Gavazzi A, van Gilst WH, Hobbs FD, Korewicki J, Madeira HC, Preda I, Swedberg K, Widimsky J, Committees IoHFP, Investigators, Improvement programme in e, management, Study Group on Diagnosis of the Working Group on Heart Failure of The European Society of C (2002) Management of heart failure in primary care (the IMPROVEMENT of Heart Failure Programme): an international survey. Lancet 360(9346):1631–1639

    Article  CAS  PubMed  Google Scholar 

  50. Shiba N, Nochioka K, Miura M, Haruka K, Shimokawa H, on behalf of the CHART-2 Investigators (2011) Trend of westernization of etiology and clinical characteristics of heart failure patients in Japan: first report from the CHART-2 study. Circ J 75:823–833

    Article  PubMed  Google Scholar 

  51. Sturm HB, Haaijer-Ruskamp FM, Veeger NJ, Balje-Volkers CP, Swedberg K, van Gilst WH (2006) The relevance of comorbidities for heart failure treatment in primary care: a European survey. Eur J Heart Fail 8(1):31–37. doi:10.1016/j.ejheart.2005.03.010

    Article  PubMed  Google Scholar 

  52. Sturm HB, van Gilst WH, Veeger N, Haaijer-Ruskamp FM (2007) Prescribing for chronic heart failure in Europe: does the country make the difference? a European survey. Pharmacoepidemiol Drug Saf 16(1):96–103. doi:10.1002/pds.1216

    Article  CAS  PubMed  Google Scholar 

  53. Bonow RO, Gheorghiade M (2014) Performance matters in heart failure. JACC 63(2):131–132

    Article  PubMed  Google Scholar 

  54. Erhardt L, Komajda M, Hobbs FDR, Soler-Soler J (2008) Cardiologists’ awareness and perceptions of guidelines for chronic heart failure. The ADDress your Heart survey. Eur J Heart Fail 10:1020–1025

    Article  PubMed  Google Scholar 

  55. van der Wal MHL, Jaarsma T (2008) Adherence in heart failure in the elderly: problem and possible solutions. Int J Cardiol 158:203–208

    Google Scholar 

  56. Wu J-R, Moser DK, Lennie TA, Peden AR, Chen Y-C, Heo S (2008) Factors influencing medication adherence in patients with heart failure. Heart Lung 37:8–16

    Article  CAS  PubMed  Google Scholar 

  57. Safford MM, Shewchuk R, Qu H, Williams JH, Estrada CA, Ovalle F, Allison JJ (2007) Reasons for not intensifying medications: differentiating “clinical inertia” from appropriate care. J Gen Intern Med 22(12):1648–1655

    Article  PubMed  PubMed Central  Google Scholar 

  58. Remme WJ (2007) Filling the gap between guidelines and clinical practice in heart failure treatment—still a far cry from reality. Eur J Heart Fail 9:1143–1145

    Article  PubMed  Google Scholar 

  59. Dokainish H, Teo K, Zhu J, Roy A, Al-Habib K, ElSayed A, Palileo L, Jaramillo PL, Karaye K, Yusoff K, Orlandini A, Sliwa K, Mondo C, Lanas F, Dorairaj P, Huffman M, Badr A, Elmaghawry M, Damasceno A, Belley-Cote E, Harkness K, Grinvalds A, McKelvie R, Yusuf S (2015) Heart failure in low- and middle-income countries: background, rationale, and design of the INTERnational Congestive Heart Failure Study (INTER-CHF). Am Heart J 170(627–634):e621

    Google Scholar 

  60. Buse JB, Ginsberg HN, Bakris GL, Clark NG, Costa F, Eckel R, Fonseca V, Gerstein HC, Grundy S, Nesto RW, Pignone MP, Plutzky J, Porte D, Redberg R, Stitzel KF, Stone NJ (2007) Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 115:114–126

    Article  PubMed  Google Scholar 

  61. Skyler JS, Bergenstal R, Bonow RO, Buse J, Deedwania P, Gale EAM, Howard BV, Kirkman MS, Kosiborod M, Reaven P, Sherwin RS (2009) Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. J Am Coll Cardiol 53:298–304

    Article  PubMed  Google Scholar 

  62. Driscoll A, Krum H, Wolfe R, Tonkin A, on behalf of The Bench Study Group (2011) Nurse-led titration of ß-adrenoreceptor blocking agents in chronic heart failure patients in the community. J Cardiac Fail 17:224–230

    Article  Google Scholar 

  63. Milfred-Laforest SK, Chow SL, Didomenico RJ, Dracup K, Ensor CR, Gattis-Stough W, Heywood JT, Lindenfeld J, Page RL II, Patterson JH, Vardeny O, Massie BM (2013) Clinical pharmacy services in heart failure: an opinion paper from the Heart Failure Society of America and American College of Clinical Pharmacy Cardiology Practice and Research Network. J Cardiac Fail 19(5):354–369

    Article  Google Scholar 

Download references

Acknowledgments

KLC receives a PhD scholarship from the Ministry of Education, Malaysia.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ingrid Hopper.

Ethics declarations

Conflict of interest

All authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Additional information

In memoriam of Henry Krum.

Appendices

Appendix 1

See Table 7.

Table 7 Risk of bias assessment

Appendix 2

See Table 8.

Table 8 Baseline characteristics in the selected registries

Appendix 3

See Table 9.

Table 9 Baseline characteristics in the selected surveys

Appendix 4

See Table 10.

Table 10 US-based studies and ACC/AHA guideline recommendations for the treatment of patients with heart failure

Appendix 5

See Table 11.

Table 11 Europe-based studies and ESC guideline recommendations for the treatment of patients with heart failure

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chin, K.L., Skiba, M., Tonkin, A. et al. The treatment gap in patients with chronic systolic heart failure: a systematic review of evidence-based prescribing in practice. Heart Fail Rev 21, 675–697 (2016). https://doi.org/10.1007/s10741-016-9575-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10741-016-9575-2

Keywords

Navigation