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ESC/HFA heart failure guidelines in clinical practice: Optimising patient outcomes

Heart Failure

Petar Seferovic.jpgProf. Piotr Ponikowski

Professor Piotr Ponikowski (Wroclaw Medical University, Wroclaw, Poland), ESC Committee for Practice Guidelines Member and Chair of the 2016 ESC Guidelines for heart failure, is a strong supporter of the ESC/HFA evidence-based guidelines for heart failure management and is determined to make clinicians aware of the importance of observing recommendations in daily practice.

“There is clear evidence that following guidelines in clinical practice improves patient outcomes,” says Prof. Ponikowski. “In a study we published last year—involving over six-and-a-half thousand outpatients with heart failure with reduced ejection fraction from the QUALIFY international registry—we found that poor physician adherence to treatment guidelines was associated with a statistically significant doubling in the risk of overall, cardiovascular and heart failure death and had an impact on hospitalisation.1” Why should clinicians choose the guidelines developed by ESC/HFA? “Our guidelines are prepared by international specialists and are updated every four years, so clinicians can be confident that they reflect current knowledge and treatments,” he says, continuing, “I visit a lot of countries around the world to find out what clinicians think about our guidelines and the feedback I get is overwhelmingly positive.” Along with the HFA, societies in ESC member countries are working hard to promote the guidelines. “National societies, such as the Polish Cardiac Society in my own country, are making every effort to raise awareness among clinicians, including providing translated versions of the guidelines,” says Prof. Ponikowski.

Part of the appeal of the guidelines lies in their ease of use, explains Prof. Ponikowski. “We have tried to ensure that there are different formats available to suit the different needs of the variety of individuals using them. We realise that the full-text versions will probably be read mainly by specialists and those involved in teaching. Busy practising clinicians are likely to find the Pocket Guidelines, which focus on treatment algorithms, more convenient, particularly as these are also available as a mobile app. And we haven’t forgotten general practitioners, who can access relevant information quickly via a series of summary cards.” Prof. Ponikowski thinks that the ‘Guidelines in daily practice’ sessions at Heart Failure 2018 will attract capacity audiences. “I remember that 8–10 years ago, when I was HFA President, there was talk that congresses were on the way out and would be replaced by web-based learning and meetings. That hasn’t happened. People continue to want face-to-face interaction,” he says. “The congress’s guidelines sessions are a perfect example of this. They are always popular, giving delegates the opportunity to hear specialists use clinical examples to explain how the guidelines can be applied in practice, to ask questions and to participate in discussion with experts and peers.”

1. Komajda M, et al. Eur J Heart Fail 2017;19:1414–1423.