GWTG-HF Program Associated With Greater Postdischarge GDMT Use

Hospital participation in the Get With The Guidelines–Heart Failure (GWTG-HF) program was associated with modestly greater postdischarge use and intensity of guideline-directed medical therapy (GDMT) among Medicare beneficiaries hospitalized with heart failure with reduced ejection fraction, according to a retrospective analysis published in Circulation: Heart Failure.

Investigators analyzed Medicare beneficiaries with Parts A and D who were hospitalized from 2013 through 2021. Using a multiple-baseline time-series design, they compared changes in treatment and outcomes before and after hospitals enrolled in GWTG-HF with changes at hospitals that never participated. The coprimary outcomes were 90-day postdischarge GDMT scores under parallel- and nonparallel-slopes models.

The analysis included 1,274,863 beneficiaries. The unadjusted median GDMT score increased from 3.0 in both groups to 4.0 at nonparticipating hospitals and 4.5 at GWTG-HF hospitals at 90 days (P<.001). After adjustment for hospital performance, patient characteristics, and temporal trends, GWTG-HF enrollment was associated with a 0.15-point higher 90-day score (P<.001).

Program participation was also associated with greater use of beta-blockers, renin-angiotensin system inhibitors, and mineralocorticoid receptor antagonists, but not angiotensin receptor-neprilysin inhibitors. In the parallel-slopes analysis, participation was associated with lower all-cause mortality at 30 days (odds ratio, 0.95) and 1 year (odds ratio, 0.97; both P<.05). These mortality differences were attenuated and were no longer statistically significant under the nonparallel-slopes model.

The investigators concluded that GWTG-HF participation was associated with modest improvements in postdischarge GDMT intensity. The study was retrospective, and the mortality findings varied according to the model used.

Source: Verma A, Fonarow GC, Heidenreich P, et al. Get With The Guidelines–Heart Failure hospital participation and its association with guideline-directed medical therapy and outcomes. Circ Heart Fail. Published online September 2, 2026. doi:10.1161/CIRCHEARTFAILURE.126.014414