Observational studyOpen heart2026
Standardised, telemonitored titration of guideline-directed medical therapy in heart failure is associated with faster optimisation and improved persistence compared to standard of care.
Observational study in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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
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Who cites it
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRapid initiation and up-titration of guideline-directed medical therapy (GDMT) are critical for improving outcomes in heart failure with reduced ejection fraction (HFrEF), yet initiation is frequently delayed and target doses are often not achieved in routine clinical care. We assessed whether a predefined standardised home-based titration strategy supported by telemonitoring enhances GDMT optimisation compared with standard of care.
methodsThis study compared the TELEmonitored FAst Standardized Titration for Efficient Response in Heart Failure with reduced ejection fraction (TELEFASTER-HF) cohort (n=60) that underwent standardised, home-based GDMT titration with a contemporaneous standard-of-care cohort (n=65). Groups were balanced using inverse probability of treatment weighting. Outcomes included time to optimal medical therapy (OMT), comparative attainment of GDMT doses at 8 weeks and GDMT persistence up to 12 months after the study index.
resultsThe time to OMT was substantially shorter in TELEFASTER-HF patients compared with the standard-of-care cohort (median 48 vs 321 days, HR 16.1, 95% CI 8.3 to 31.2, p<0.001). Compared with standard-of care, TELEFASTER-HF care was associated with higher GDMT dose categories and achievement of higher rates of GDMT target doses across all drug classes needing titration at all follow-up time points. Exploratory analyses showed no heart failure hospitalisations in the TELEFASTER-HF group during 12 months from index compared with 26 events in the control cohort.
conclusionsA standardised, telemonitored, home-based GDMT titration strategy was associated with faster, more comprehensive and more durable optimisation of GDMT in patients with HFrEF compared with standard of care. This approach may help address persistent GDMT implementation gaps.
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