Comparison of chronic systolic heart failure guideline adherence for two ambulatory clinics

  • Sarah B. Dehoney
  • Lori M. Dickerson
  • Jean M. Nappi
Keywords: Heart Failure, Systolic, Drug Therapy, Guideline Adherence, United States


Guidelines have been published for management of chronic systolic heart failure to reduce patient morbidity and mortality.

Objective: A quality review of the heart failure medical therapy for a community family medicine residency program clinic and a multidisciplinary heart failure specialty clinic was performed to compare adherence to ACC/AHA heart failure guidelines, with regard to medications and in titrating to recommended target doses.

Methods: The study was a retrospective chart review and data collected included name and dose of any ACEI, beta-blocker, ARB, or other medication addressed in the guidelines.

Results: Specialty clinic patients had significantly lower systolic blood pressures and ejection fractions. Significantly more patients were prescribed beta-blockers in the specialty clinic population (98% vs 80%, p<0.05). Both patient populations had very low rates of reaching target beta-blocker doses (15% vs 21%, p=0.27). More patients in the family medicine clinic reached target doses of ACEI (64% vs 49%, p<0.05) and ARBs (67% vs 35%, p<0.05).

Conclusions: This study revealed the vast majority of patients in either a community family medicine residency program or heart failure specialty clinic were prescribed ACEI or ARB, and beta-blockers. However, achieving target doses should continue to be an important goal for practitioners.


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How to Cite
Dehoney SB, Dickerson LM, Nappi JM. Comparison of chronic systolic heart failure guideline adherence for two ambulatory clinics. Pharm Pract (Granada) [Internet]. 2010Mar.15 [cited 2019Jul.17];8(1):56-1. Available from:
Original Research