SynthesisHeart failure reviews2016
The treatment gap in patients with chronic systolic heart failure: a systematic review of evidence-based prescribing in practice.
Synthesis in Heart failure reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A conceptual model of factors potentially influencing prescribing decisions for chronic conditions: an overview of systematic reviews.BMC medicine · 2025Pooled it
- Factors associated with non-use and sub-target dosing of medical therapy for heart failure with reduced ejection fraction.Heart failure reviews · 2022Pooled it
- Medications that reduce emergency hospital admissions: an overview of systematic reviews and prioritisation of treatments.BMC medicine · 2018Pooled it
- Primary Prevention Implantable Cardioverter Defibrillators in Patients With Nonischemic Cardiomyopathy: A Meta-analysis.JAMA cardiology · 2017Pooled it
- Differences in NT-proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction.Journal of the American Heart Association · 2021Trial
- Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure.Clinical interventions in aging · 2018Trial
- Age, creatinine, and ejection fraction score is a risk factor for acute kidney injury after surgical aortic valve replacement.Renal failure · 2025Article
- Older patients with heart failure managed in primary care versus cardiology care: a register-based study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Physicians' information-seeking, appraising, and clinical decision-making practices for drug prescriptions: an exploratory study.Journal of the Medical Library Association : JMLA · 2025Article
- Association of Medication Adherence and Health Status in Heart Failure With Reduced Ejection Fraction: Insights From the CHAMP-HF Registry.Circulation. Cardiovascular quality and outcomes · 2024Observational
- Potassium homeostasis and therapeutic intervention with sodium zirconium cyclosilicate: A model-informed drug development case study.CPT: pharmacometrics & systems pharmacology · 2024Article
- Association between performance measures and clinical outcomes in patients with heart failure in China: Results from the HERO study.Clinical cardiology · 2024Article
- Impact of Multidisciplinary Heart Failure Clinic on Guideline-Directed Medical Therapy and Clinical Outcomes.The Canadian journal of hospital pharmacy · 2024Article
- Identifying Barriers and Facilitators for Increasing Uptake of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors in British Columbia, Canada, using the Consolidated Framework for Implementation Research.Canadian journal of kidney health and disease · 2024Article
- Design and pilot implementation for the BETTER CARE-HF trial: A pragmatic cluster-randomized controlled trial comparing two targeted approaches to ambulatory clinical decision support for cardiologists.American heart journal · 2023Article
- Article
- Characteristics and management of very elderly patients with heart failure: a retrospective, population cohort study.ESC heart failure · 2023Article
- Missed opportunities in medical therapy for patients with heart failure in an electronically-identified cohort.BMC cardiovascular disorders · 2022Article
- A qualitative analysis of the barriers and enablers faced by Australian rural general practitioners in the non-pharmacological management of congestive heart failure in community dwelling patients.BMC health services research · 2022Article
- Pathophysiology and Therapeutic Approaches to Acute Decompensated Heart Failure.Circulation research · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
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.
Indexed as
Identifiers
27465132What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.