Patients With Heart Failure and ESC Guidelines
Patients With Heart Failure and ESC Guidelines
Evidence-based clinical practice guidelines have been developed for the treatment of patients with HF; however, substantial gaps and variations currently exist in the quality of care provided to patients with HF. The data collected in this registry show that, while in patients with acute HF a large heterogeneity of treatments exists, mainly due to the absence of clear evidence-based recommendations, the pharmacological treatment of patients with chronic HF can be considered acceptably adherent to the recommendations of current guidelines. This is because the real rate of undertreatment or underdosage of drugs is shown to be limited when the reasons for non-adherence are appropriately taken into account. With respect to device implantation, the gap between guidelines and practice seems to be greater, probably due to different local medical practice but also to differences in healthcare systems.
Observations regarding the real possibility to adhere fully to current guidelines in daily clinical practice should be taken into account when clinical practice guidelines are written, also because guideline recommendations are increasingly perceived as mandatory for all patients, with potential legal consequences if they are abrogated.
Conclusions
Evidence-based clinical practice guidelines have been developed for the treatment of patients with HF; however, substantial gaps and variations currently exist in the quality of care provided to patients with HF. The data collected in this registry show that, while in patients with acute HF a large heterogeneity of treatments exists, mainly due to the absence of clear evidence-based recommendations, the pharmacological treatment of patients with chronic HF can be considered acceptably adherent to the recommendations of current guidelines. This is because the real rate of undertreatment or underdosage of drugs is shown to be limited when the reasons for non-adherence are appropriately taken into account. With respect to device implantation, the gap between guidelines and practice seems to be greater, probably due to different local medical practice but also to differences in healthcare systems.
Observations regarding the real possibility to adhere fully to current guidelines in daily clinical practice should be taken into account when clinical practice guidelines are written, also because guideline recommendations are increasingly perceived as mandatory for all patients, with potential legal consequences if they are abrogated.
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