Barriers to Optimization of Medical Therapy and the Role of Checklist‐Based Decision Support in Heart Failure

09 Jun 20264 min read0 viewsJournal Feed

GIST (Key Takeaways)

Journal of the American Heart Association, Volume 15, Issue 12 , June 16, 2026. Background.
Guideline‐directed medical therapy (GDMT) reduces morbidity and mortality in heart failure with reduced ejection fraction, yet it remains underused. Patient‐activation interventions, including checklist‐based decision support, have shown improvement in GDMT optimization, and iterative refinement of such tools may enhance their impact.
We analyzed recorded clinician–patient encounters, in which a checklist‐based activation tool was used, to identify barriers to GDMT optimization and opportunities to enhance decision support. Methods.
This was a secondary analysis of transcript data from the POCKET‐COST‐HF (Integrating Cost Into Shared Decision‐Making for Heart Failure With Reduced Ejection Fraction) trial, which implemented a checklist‐based tool focused on prescription price transparency. Patients and clinicians at 2 academic health centers received adapted versions of the EPIC‐HF (Electronically Delivered Patient‐Activation Tool for Intensification of Medications for Chronic Heart Failure With Reduced Ejection Fraction) checklist outlining approved medications and target doses for HFrEF.