Heart failure guidelines implementation: Lifting barriers using registries and networks

Heart failure (HF) is a disorder that is characterized by poor prognosis, comparable to that for cancer, despite treatment advances. The underutilization of disease-modifying drugs and devices is a major reason for the poor prognosis despite overwhelming evidence from clinical-trials and strong recommendations established in national and international guidelines. Several surveys and registries have confirmed that patients who are not treated with the recommended therapy or are treated with a low dose have a higher risk of hospitalization and/or death (1). Adherence to guidelines and implementation of evidence-based treatment is difficult, and there is no consensus on the optimal implementation strategy (2). There is wide regional variation and space for improvement (3, 4), with the first and most important step in this process being the organization of a national HF clinics network, initiation of national registries, and quality improvement programs (5, 6).