Clinical Report: How Quickly Are Patients Reaching Quadruple HFrEF Therapy?

Overview

A retrospective cohort study found that less than 25% of veterans with newly diagnosed heart failure with reduced ejection fraction (HFrEF) achieved quadruple therapy within a median follow-up of 2.9 years, with a median time to therapy exceeding 6 months.

Background

Heart failure with reduced ejection fraction (HFrEF) is a major health concern, with established guidelines recommending concurrent use of four specific drug classes.

Data Highlights

Key Findings

• Less than 25% of veterans with newly diagnosed HFrEF achieved quadruple therapy within 2.9 years.
• The median time to achieve quadruple therapy was over 6 months.
• Prescription copays were associated with lower rates of achieving quadruple therapy.
• Adjusted rates of quadruple therapy were higher among Black and Hispanic patients compared to White patients.
• Patients diagnosed in the outpatient setting were more likely to achieve quadruple therapy than those diagnosed in the inpatient setting.

Clinical Implications

The findings indicate a need for targeted interventions to improve the initiation of quadruple therapy in veterans with HFrEF. Addressing barriers such as prescription copays and enhancing outpatient management strategies may facilitate better adherence to guideline-directed medical therapy.

Conclusion

The study reveals significant delays and low rates of quadruple therapy initiation among veterans with HFrEF.

Related Resources & Content

1. Joshua A. Jacobs, PharmD, PhD, et al., JAMA Cardiology, 2026 -- How Quickly Are Patients Reaching Quadruple HFrEF Therapy?
2. conexiant — Quadruple Therapy in HFrEF: What Happens Next?
3. The New Gastroenterologist — Comparative Efficacy of Quadruple versus Triple Therapy for H. pylori Eradication
4. Clinical Research in Cardiology — Recent Developments in Clinical Trials for Heart Failure
5. JAMA Network Open — Heart Failure Trajectories After Guideline-Directed Medical Therapy
6. Quadruple Therapy in HFrEF: What Happens Next?
7. Recent Developments in Clinical Trials for Heart Failure
8. Prioritizing Time from Diagnosis to Quadruple Therapy in Heart Failure Care | Cardiology | JAMA Cardiology | JAMA Network
9. Pharmacologic Treatment of Heart Failure With Reduced Ejection Fraction: An Updated Systematic Review and Network Meta-Analysis | JACC
10. Time to Quadruple Therapy After Diagnosis of HFrEF