Integrating heart failure guidelines into clinical practice

Chronic heart failure is a complex syndrome that is associated with increasing prevalence due to the ageing of the global population. Effective pharmacological treatments and evidence-based diagnostic and treatment guidelines are available for the optimum management of patients with this condition; however, many patients do not receive the medications they require or are given suboptimal doses of appropriate treatments. Underutilization of effective therapies continues to present a challenge in heart failure management and results in considerable human and financial consequences. Widespread undertreatment stems from a range of factors including diagnostic challenges, physicians' prescribing patterns, poor patient adherence to prescribed medications, a lack of effective screening programmes or specialized heart failure units, and the absence of national registries in many countries, which enable the incidence of heart failure to be monitored accurately. Global adoption of a range of strategies including the education of healthcare workers and patients, the dedication of hospital and outpatient facilities to heart failure management, and adequate discharge planning may enable adherence to guidelines to be improved and the benefits of effective treatments to be maximized.