Get With the Guidelines–Heart Failure: 20 Years in Review, Lessons Learned, and the Road Ahead

The American Heart Association’s Get With The Guidelines–Heart Failure (GWTG-HF) program has marked 20 years of supporting hospitals in treating patients with heart failure. The program was launched in 2005 to support hospitals in meeting the latest guidelines and improving the care given to patients.

Since its launch, more than 600 hospitals across the US have joined the program. These institutions gain access to toolkits and online learning, and receive regular feedback on their performance. Hospitals that comply with important requirements, including medication and discharge instructions, are acknowledged by the American Heart Association.

The findings are impressive. Beta-blockers, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers are now the first choice for many hospitals treating heart disease. New drugs, such as angiotensin receptor-neprilysin inhibitors (ARNIs) and SGLT2 inhibitors, have recently gained popularity due to their ability to reduce hospital visits and improve patient outcomes.

Initially, hospitals were hesitant to use these new drugs after they were approved. For instance, not even 2.3% of those who could have benefited from ARNIs initially received them. Eventually, the use of these treatments in hospitals increased because the program provided data and feedback. However, some people cannot access the best treatments because of high medication prices or insurance-related problems.

One of the most important features of the program is its extensive patient registry. With data from over 3 million patients with heart failure in 626 hospitals, the registry supports studies, enables researchers to monitor progress, and facilitates the sharing of their findings. As a result, more than 170 studies have been done using this information, influencing guidelines for treating health issues and making health policy decisions.

At the same time, the program highlights areas that require further development. It has been shown that some patients do not receive the same level of care. People living in rural areas, as well as women and members of racial and ethnic minorities, are less likely to obtain the best treatments. The American Heart Association is making efforts to ensure fair treatment for all patients by reducing these care gaps.

Despite the success of the program, many people are still hospitalized for heart failure, and there has been only a small decline in deaths. A 2021 -2022 study noted that only half of eligible patients received aldosterone antagonists. Of the patients, 28.5% were prescribed ARNIs, while 20.2% received SGLT2 inhibitors.

There is room for better use of these medications. Experts are trying to understand why certain groups get substandard care and searching for ways to improve it. Certain social factors, such as income, race, and location, may be involved.

By using new technologies, the program could improve. Currently, most data collection is done manually, which makes the process slow and costly. Using AI-powered systems can capture medical data directly from electronic health records, thereby speeding up the process.

In the future, the program aims to provide additional tools, such as resources for patients to manage their care, and increased integration with insurance data, including Medicare Advantage. Currently, GWTG-HF is available only to hospitals that sign up; however, in the future, it may be used to guide treatment for the broader U.S. public with various types of data.

Over the past 20 years, GWTG-HF has greatly improved the way hospitals manage heart failure. By making updates, addressing gaps in care, and assisting hospitals, the program aims to help more patients live longer and healthier lives.