Bridging Treatment Implementation Gaps in Patients With Heart Failure: JACC Focus Seminar 2/3

Mohamed B. Jalloh, Tauben Averbuch, Prashanth Kulkarni, Christopher B. Granger, James L. Januzzi, Faiez Zannad, Robert W. Yeh, Clyde W. Yancy, Gregg C. Fonarow, Khadijah Breathett, C. Michael Gibson, Harriette G.C. Van Spall

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Heart failure (HF) is a leading cause of death and disability in older adults. Despite decades of high-quality evidence to support their use, guideline-directed medical therapies (GDMTs) that reduce death and disease burden in HF have been suboptimally implemented. Approaches to closing care gaps have focused largely on strategies proven to be ineffective, whilst effective interventions shown to improve GDMT uptake have not been instituted. This review synthesizes implementation interventions that increase the uptake of GDMT, discusses barriers and facilitators of implementation, summarizes conceptual frameworks in implementation science that could improve knowledge uptake, and offers suggestions for trial design that could better facilitate end-of-trial implementation. We propose an evidence-to-care conceptual model that could foster the simultaneous generation of evidence and long-term implementation. By adopting principles of implementation science, policymakers, researchers, and clinicians can help reduce the burden of HF on patients and health care systems worldwide.

Original languageEnglish (US)
Pages (from-to)544-558
Number of pages15
JournalJournal of the American College of Cardiology
Issue number6
StatePublished - Aug 8 2023
Externally publishedYes


  • clinical trials
  • conceptual frameworks
  • guideline-directed medical therapies
  • heart failure
  • implementation science

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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