Evaluation of Adherence to European Society of Cardiology Guidelines for Heart Failure Patients in Shahid Modarres Hospital

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Abstract
Background: The prevalence of heart failure (HF) presents a significant burden on global healthcare systems, accounting for approximately 1.2% of the total healthcare budget. Adherence to the European Society of Cardiology (ESC) guidelines is associated with improved clinical outcomes, fewer cardiovascular hospitalizations, and delayed rehospitalization. Objectives: Given the lack of studies on compliance with ESC guidelines for HF patients in Iranian hospitals, this study aimed to evaluate the compliance of HF treatment at Shahid Modarres Hospital with the ESC guidelines. Methods: This descriptive cross-sectional study was conducted on 97 patients with HF who were referred to Shahid Modarres Hospital, Tehran, in 2023. Patients were diagnosed based on their medical records and clinical evaluations by a cardiologist. Medications were reviewed for compliance with the ESC guidelines regarding drug category, type, and dosage. Results: The results showed that 42.3% of patients received treatment in compliance with the ESC guidelines, while 57.7% had non-compliance. The most common non-adherence was observed in the use of ACE/ARB, mineralocorticoid receptor antagonists (MRAs), and Empa/Dapa drug combinations. The study found that 57% of patients were already being treated at Modarres Hospital, and treatment compliance was higher among these patients (60%), compared to those who referred to the hospital for the first time (30%). Conclusions: Although the HF treatment compliance rate at Shahid Modarres Hospital is high, it still requires improvement. A thorough examination of the underlying reasons for non-adherence to HF medication guidelines is needed, with the goal of identifying and addressing potential barriers to optimal treatment.

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