OBJECTIVES:

By 2030, it is estimated that the prevalence and total cost of heart failure (HF) will increase by 46% and 127%, respectively. Despite that the American College of Cardiology (ACC) and American Heart Association (AHA) published a clear and updated clinical practice guideline for the treatment of HF, a study showed that adherence of physician to the guideline-recommended therapy was good in only 23% of patients. The aim is to describe the prescribing patterns for patients with heart failure at discharge.

METHODS:

A retrospective chart review was conducted on 408 adult patients who were diagnosed with HF at discharge during January 2017 to January 2018 in Riyadh at KACC and internal medicine wards in KAMC. Collected data includes: Demographics, type of heart failure, selected medical history, vital signs/clinical parameters and prescribed treatments for heart failure at discharge. Statistical analyses were performed using SAS software 9.4.

RESULTS:

• The percentage of patients receiving both ACEI/ARB and BB was only 36.27%. In addition, aldosterone antagonist (AA) were prescribed for 17.4% of patients receiving BB and 15.44% of patients receiving ACEI/ARB.
• Almost 33% of patients received 3 medications and 3.92% were discharged with no therapy for HF.

CONCLUSIONS:

• The ACC/AHA guideline stated a class I recommendation level A of evidence that HF patients should be receiving ACEI/ARBS together with beta-blocker and AA. However, our results showed that 63.73% did not receive ACEI/ARB and beta-blocker in conjugation.
• Although the percentage of prescribing ACEI/ARBS was not optimal (53.68%) as compared with another study that reported a percentage of 76%, this can be justified by the moderate percentage of prescribing hydralazine (12.99%) and nitrate (16.42%), which are an alternative for ACEI/ARBS in case of contraindication and drug intolerance.

• Our study reveals the need for further research to investigate reasons resulted in non-adherence to guideline-recommended therapy.