It was previously announced that, as of October 2025, quarterly reports would be sent from Cardiovascular Care Alberta to physicians who cared for patients hospitalized with heart failure with reduced ejection fraction (HFrEF; LVEF ≤ 40%), with the goal to optimize guideline directed medical therapy (GDMT) in patients. Below is further information on this initiative.
Why are physicians who treat heart failure patients receiving quarterly reports?
Cardiovascular Care Alberta is leading an evidenced-based data-driven care optimization initiative for patients admitted with HF at acute care hospital sites across the province. Patient outcomes are improved when all four therapies are optimized (Canadian Cardiovascular Society Heart Failure guideline recommendations [McDonald M et al. Can J Cardiol 2021; 37: 531-546]; click the camera icon to see figure). Patients with HFrEF may be frequently hospitalized, which provides an opportunity to advance care.
An increase in 10% in optimal GDMT was associated with significant reductions in [Cotter G et al. JAMA Cardiol 2024; 9(2): 114-124]:
- 180-day HF readmissions or all cause death (adjusted HR 0.89; 95% CI 0.81-0.98; p=0.01); and
- 180-day all-cause mortality (adjusted HR 0.84; 95% CI 0.73-0.95; p=0.007).
What is the goal?
Target: As reflected in the inaugural October 1, 2025 reports (seen here), adherence to prescribing all four medications remains suboptimal at 42% and Modified Heart Failure Collaboratory Score (mHFC) at 64% (n=893; January 1-March 31, 2025). While the results reported address indication and contra-indications to therapy, target scores will vary because each patient treatment optimization depends on a variety of factors and clinical judgement. Improvement can be measured by higher scores over time.
Through patient level data-driven feedback, the aim of this initiative is to highlight areas for enhancement and support reflective practice. Individual reports are confidential and will not be shared; only managing healthcare providers will receive their own data.
Therapeutic goal: To have patients with HFrEF receive appropriate foundational GDMT (if tolerated) prior to HF hospitalization discharge.
Data and Feedback Timing
The reports reflect a 3-month data lag based on the Discharge Abstract Database. While retrospective data is useful, we recognize that the most effective time for feedback is during direct patient care. Physicians are encouraged to access real-time Connect Care GDMT feedback (for details, see: GDMT and mHFC detail summary).
Further Information
Questions can be emailed to: CardiovascularCareAlberta@acutecarealberta.ca.
