Quality of Care of Patients with Stable and Stabilized Heart Failure with Reduced Ejection Fraction at the Medical Wards of a Tertiary Center in the Philippines: A Retrospective Cross-sectional Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Heart failure with reduced ejection fraction (HFrEF) remains a major contributor to morbidity and mortality among Filipinos. Contemporary ESC and ACC/AHA guidelines emphasize quality indicators aimed at optimizing outcomes. Objective: The study aimed to evaluate the quality of care received by stable and stabilized HFrEF patients admitted to the medical wards of a tertiary center in the Philippines, focusing on physician adherence to guideline-recommended quality indicators. Methods: A cross-sectional study was done through review of charts involving all adult HFrEF patients aged ≥19 years admitted to the medical wards of a tertiary hospital from November 2022 to April 2023. Quality-of-care assessment included prescription of Class I guideline-directed medical therapy (GDMT) at discharge for eligible patients, as well as non-pharmacologic indicators such as scheduling of post-discharge follow-up and referrals to a heart failure clinic or cardiac rehabilitation. Descriptive statistics were used; analyses were performed using STATA 13.1. QI of 80% was considered to be optimal quality of care. Results: A total of 148 patients were included; most were male (69.6%) with a mean age of 56 ± 14 years. Hypertension (62.8%) and diabetes (41.2%) were the most frequent comorbidities. Beta-blockers, ACEi / ARB / ARNI, and diuretic prescription were high (95.17%, 91.41%, and 100%, respectively). In contrast, prescription of MRA and SGLT2i was 68.50% and 55.56%, respectively. Post-discharge physician appointments within 4 weeks were arranged in 91.54%. Only 27.7% were referred to cardiac rehabilitation, and 2.31% were referred to the heart failure clinic. Conclusion: Quality of heart failure care at the medical wards upon discharge is acceptable for pharmacologic quality indicators and post-discharge appointments. However, referrals to specialized heart failure services and cardiac rehabilitation remain suboptimal and represent opportunities for quality improvement.
Source: Acta Medica Philippina
Authors: Sherry Mae C. Mondido, MD, Felix Eduardo R. Punzalan, MD, Kevin D.A. Enriquez, MD, Ronald B. Roderos, MD, Nigel Jeronimo C. Santos, MD, Tam Adrian P. Aya-ay, MD, Mark John D. Sabando, MD, Bai Sitti Ameerah Asleah B. Tago, MD, Zane Oliver M. Nelson III, MD, Marie Kirk Patrick A. Maramara, MD, Lauren Kay M. Evangelista, MD
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7203678253