Chronic heart failure (CHF) remains a leading cause of decreased quality of life and rehospitalization. Achieving target drug doses and high patient adherence are key factors influencing the prognosis of the disease; however, in real-world clinical practice, these indicators often remain low.

Study Objective: To evaluate the effectiveness of CHF drug therapy (achievement of target drug doses) and patient adherence to treatment using data from the Tyumen Oblast CHF registry.

Materials and Methods: Data from 7303 patients with CHF (FC I–IV) included in the Tyumen Oblast registry from 2020 to 2023 were analyzed. The frequency of prescription and achievement of target doses of key drug groups (ACE inhibitors/ARBs/ARNIs, beta-blockers, and АА) was assessed depending on the CHF phenotype (CHFrEF, CHFunEF, CHFpEF). Adherence was assessed subjectively (survey) and objectively (monitoring of subsidized drug provision).

Results:

1. Target doses of AA were achieved in 93% of cases. However, target doses of beta-blockers were achieved in only 15.6% of patients, and those of ACE inhibitors/ARBs/ARNIs were achieved in 16% (p<0.001). The average daily doses of most medications were below the recommended target doses.

2. High adherence to prescribed treatment was found in only 50.6% of patients.

3. Repeated assessment of LVEF was performed in only 22.4% of patients, and NT-proBNP in 29.4%. However, in patients on OMT with a baseline low LVEF, an increase in LVEF by >10% (p<0.001) was observed in 67.5% of cases, while a decrease in NT-proBNP levels by >10% was observed in 50.4% of patients on OMT.

Conclusions: In the real-world clinical practice of the Tyumen Region CHF registry, insufficient achievement of target doses of key pathogenetic drugs (with the exception of АА) and low patient adherence to treatment are observed. Patients receiving OMT demonstrate significant improvement in key parameters (LVEF, NT-proBNP).The obtained registry data substantiate the need for more active follow-up and education of physicians and patients to improve disease management.

Anna Arturovna Airapetian is a cardiologist, geriatrician, and laboratory research assistant at the E.I. Chazov National Medical Research Center of Cardiology.