Overview
Pathways for Optimal Sequencing, Rapid Initiation, and Titration of Therapy in Patients with Heart Failure
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Many patients with heart failure (HF) do not receive foundational treatment although these therapies reduce morbidity and mortality risks. The initiation and optimization of guideline-directed medical therapies (GDMT) can be challenging, but clinical practice guidelines and algorithms are available to assist. Navigate through this interactive self-directed CME activity to apply the most recent clinical trial data and guidance to patient-specific factors seen in real-world practice. Expert perspectives and available evidence will help you implement GDMT in practice to improve patient quality of life, prevent rehospitalization, and reduce mortality risks in your patients with HF.
This activity is intended for cardiologists, clinical nurse specialists, advanced practice providers in cardiology care, hospitalists, internists, primary care clinicians, and other healthcare providers who are members of the HF healthcare team.
HF is a complex disease associated with adverse outcomes and poor quality of life for patients. It is also a significant driver of hospitalizations and readmissions. Delays in diagnosis, misdiagnosis, and undertreatment are common as patients often see a multitude of healthcare providers. Yet, early recognition and treatment are critical to reducing morbidity and mortality associated with HF. There have been significant advances in treatment with new disease-modifying agents introduced. Despite the accumulating evidence and calls for guideline-directed medical therapy, this approach is underutilized and clinicians struggle to initiate and optimize therapy in clinical practice. This decision tree with expert commentary can help clinicians overcome challenges.
Upon completion of this activity, learners will be able to:
- Review the latest guidance on initiation and titration of therapies across classifications of HF by left ejection fraction
- Discuss unmet needs and clinical practice gaps stemming from sequential therapy initiation of HF therapies
- Create individualized HF treatment plans for optimal sequencing, rapid initiation, and titration of comprehensive disease-modifying medical therapy in eligible patients
Provided by the Academy for Continued Healthcare Learning (ACHL).
Supported by independent medical educational grants from Boehringer Ingelheim Pharmaceuticals, Inc. and Eli Lilly and Company.
Biykem Bozkurt, MD, PhD, FACC, FAHA, FHFSA, FACP
Senior Dean of Faculty, Baylor College of Medicine
The Mary and Gordon Cain Chair and Professor of Medicine
Director, Winters Center for Heart Failure Research
Assoc. Director, Cardiovascular Research Institute
Baylor College of Medicine
Houston, TX
Senior Dean of Faculty, Baylor College of Medicine
The Mary and Gordon Cain Chair and Professor of Medicine
Director, Winters Center for Heart Failure Research
Assoc. Director, Cardiovascular Research Institute
Baylor College of Medicine
Houston, TX
Nihar R. Desai, MD, MPH
Associate Professor of Medicine
Vice Chief, Clinical Operations, Section of Cardiovascular Medicine
Investigator, Center for Outcomes Research and Evaluation
Yale School of Medicine
New Haven, CT
The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with all ineligible companies. All relevant financial relationships have been mitigated prior to this activity.
The following financial relationships have been provided:
Biykem Bozkurt, MD, PhD, FACC, FAHA, FHFSA, FACP
Advisory Board: Abbott, Abiomed, American Regent, Amgen, Astra Zeneca, Bayer, Boehringer Ingelheim, Cardurion, Cytokinetics, Daiichi Sankyo, Johnson & Johnson, Lantheus, Liva Nova, Merck, Regeneron, Renovacor, Respicardia/Zoll, Roche, Sanofi-Aventis, Vifor
Nihar Desai, MD, MPH
Consultant (Occasional): AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Cytokinetics, Vifor
Grant/Research Support Recipient: Amgen, AstraZeneca, Boehringer Ingelheim, Cytokinetics, Vifor
Independent Contractor: Novartis
Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: None
ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.
The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).
This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.
This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.
This activity will take approximately 90 minutes to complete. To receive credit, learners are required to complete the pretest, view the online activity, and complete the posttest and evaluation. To receive credit, 80% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.
The Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Academy for Continued Healthcare Learning designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physician assistants, nurse practitioners, and nurses may participate in this educational activity and earn a certificate of completion as AAPA, AANP, and ANCC accept AMA PRA Category 1 Credits™ through their reciprocity agreements.
Completion of this activity, including the pretest, posttest, and follow-up assessments, qualifies as a medium weight MIPS improvement activity under MACRA and can be claimed as completion of IA_PSPA 28 of an Accredited Safety or Quality Improvement Program in the Quality Payment Program. Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website. You will receive additional information after completing the activity and receiving your certificate via email.
