ArticleEuropean heart journal2026
Heart failure with reduced ejection fraction in Sweden: patient adherence and persistence to quadruple pharmacotherapy prescription.
Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Longitudinal loop diuretic use in patients with HFrEF initiated with sodium-glucose cotransporter 2 inhibitors.European heart journal. Cardiovascular pharmacotherapy · 2026Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
BACKGROUND AND
aimsReal-world uptake of heart failure with reduced ejection fraction (HFrEF) treatments relies on physician prescriptions but also on patient adherence. This study assessed implementation of, patient adherence and persistence with quadruple HFrEF therapy in the contemporary setting, and associations with morbidity/mortality.
methodsPatients with HFrEF enrolled in the Swedish Heart Failure Registry between January 2016 and December 2023 were included. Using pharmacy refills, patients with ≥80% proportion of days covered were categorized as adherent and with dispensations at 12 ± 2 months post-index as persistent.
resultsIn 35 215 patients with HFrEF [median age 74 (interquartile range 64-80) years; 28% female], use of all four HFrEF foundational therapies increased between 2016 and 2023: in 2023, 93% used beta-blockers (BB), 95% renin-angiotensin-system inhibitors (RASi)/angiotensin receptor-neprilysin inhibitors (ARNi), 73% mineralocorticoid receptor antagonists (MRA), 83% sodium-glucose co-transporter 2 inhibitors (SGLT2i), and 60% quadruple therapy. The proportion of patients who were adherent and persistent, respectively, to BB was 95% and 90%, RASi/ARNi 95% and 89%, MRA 90% and 77%, SGLT2i 94% and 86%, and quadruple therapy 85% and 67%. Good adherence and persistence for BB, RASi/ARNi, and MRA and good adherence for SGLT2i were independently associated with lower heart failure hospitalization/cardiovascular death.
conclusionsBy 2023, use of quadruple therapy reached ∼60%, being mostly limited by lower adoption of MRA (∼73%). Patient adherence to foundational therapies was high and appeared associated with better prognosis. These data suggest that improvements in the uptake of and adherence to quadruple HFrEF pharmacotherapy are achievable in real-word heart failure care, although suboptimal dosing and frequent discontinuations remain important areas of further implementation.
Indexed as
Identifiers
What 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.