How to tackle therapeutic inertia in heart failure with reduced ejection fraction : a scientific statement of the Heart Failure Association of the ESC

Savarese, Gianluigi (author), Lainščak, Mitja (author)

Guideline-directed medical therapy (GDMT) in patients with heart failure and reduced ejection fraction (HFrEF) reduces morbidity and mortality, but its implementation is often poor in daily clinical practice. Barriers to implementation include clinical and organizational factors that might contribute to clinical inertia, i.e. avoidance/delay of recommended treatment initiation/optimization. The spectrum of strategies that might be applied to foster GDMT implementation is wide, and involves the organizational set-up of heart failure care pathways, tailored drug initiation/optimization strategies increasing the chance of successful implementation, digital tools/telehealth interventions, educational activities and strategies targeting patient/physician awareness, and use of quality registries. This scientific statement by the Heart Failure Association of the ESC provides an overview of the current state of GDMT implementation in HFrEF, clinical and organizational barriers to implementation, and aims at suggesting a comprehensive framework on how to overcome clinical inertia and ultimately improve implementation of GDMT in HFrEF based on up-to-date evidence.

• Language: English
• Keywords: clinical inertia, guideline-directed medical therapy, heart failure, heart failure with reduced ejection fraction, implementation
• Work type: Article
• Typology: 1.03 - Other scientific articles
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: Str. 1278-1297
• Numbering: Vol. 26, no. 6
• PID: 20.500.12556/RUL-183024
• UDC: 616.1
• ISSN on article: 1388-9842
• DOI: 10.1002/ejhf.3295
• COBISS.SI-ID: 225693955
• Publication date in RUL: 02.06.2026

Record is a part of a journal

• Title: European journal of heart failure
• Shortened title: Eur. j. heart fail.
• Publisher: Wiley, European Society of Cardiology
• ISSN: 1388-9842
• COBISS.SI-ID: 1217301

Licences

• License: CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
• Link: http://creativecommons.org/licenses/by-nc/4.0/
• Description: A creative commons license that bans commercial use, but the users don’t have to license their derivative works on the same terms.

Secondary language

• Language: Slovenian
• Keywords: klinična inercija, s smernicami usmerjena medicinska terapija, srčno popuščanje, srčno popuščanje z zmanjšanim iztisnim deležem, implementacija

Projects

• Funder: Italy, Ministry of Health
• Funding programme: Ricerca corrente