{"id":"6c83ab4923a5","type":"article","url":"https://hartvaat.nl/2026/02/23/pathfinder-trial-betere-naleving-van-hartfalenrichtlijnen-in-de-huisartsenprakti/","title":"PATHFINDER-trial: betere naleving van hartfalenrichtlijnen in de huisartsenpraktijk","title_en":"Primary care Adherence To Heart failure guidelines in post-Discharge, Evaluation & Routine management (PATHFINDER): a randomised controlled trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts"],"tags":["esc-2026","pathfinder-trial"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag061","source_url":"https://doi.org/10.1093/eschf/xvag061","authors":["Liying Dai","Tashi Dorje","Jan Gootjes","Amit Shah","Lawrence Dembo","Graham S Hillis","Angela Jacques","Hui Jun Chih","James Rankin","John J Atherton","Suzanne Robinson","Christopher M Reid","Andrew Maiorana"],"significance":6,"published":"2026-02-23","source_date":"2026-02-23","image":"","kennis":[],"congress":"esc-2026","summary_en":"The PATHFINDER trial tested a combined intervention of inpatient education, a discharge plan with cardiac rehabilitation referral, and primary care support for heart failure, evaluating implementation strategies for guideline adherence.","created":"2026-07-03T10:25:00Z","updated":"2026-08-10T11:07:51Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De PATHFINDER-trial onderzocht een gecombineerde interventie — educatie tijdens opname, een ontslagplan met verwijzing naar hartrevalidatie en geplande huisartscontroles — om de naleving van hartfalenrichtlijnen in de eerste lijn te verbeteren na een ziekenhuisopname.","abstract_original":"BACKGROUND AND AIMS: Heart failure (HF) management guidelines offer evidence-based recommendations but can be difficult to implement in primary care. This randomised controlled trial evaluated a multifaceted intervention to improve adherence to pharmacological and non-pharmacological HF management guidelines in primary care. METHODS AND RESULTS: Patients hospitalised with HF were randomised 1:1 to an intervention or control group. The intervention group received guideline-based inpatient education, a post-discharge plan including referral to cardiac rehabilitation (CR) and scheduled general practitioner follow-ups at 1 and 4 weeks, and 3 months, supported by a cardiologist-approved medication titration plan. The control group received usual care. The primary outcome, measured at 6 months, was adherence to five recommended treatments: i) ACEI/ARB/ARNI ≥50% target dose, ii) beta blocker ≥50% target dose, iii) MRA at any dose, iv) anticoagulation for atrial fibrillation, and v) CR referral. Adherence was compared using Chi-squared tests and logistic regression.Of 225 participants (25% female), a greater proportion in the intervention group achieved the primary outcome (61.8% vs. 28.7%; p<0.01). The unadjusted odds ratio showed that the intervention group was 6.27 times more likely to achieve the outcome compared to the control group (95% CI, 3.35-11.76, p<0.01). This difference was driven by higher prescription rates of ACEI/ARB/ARNI and beta blocker, and higher referral rates to CR. CONCLUSION: Hospital-based support for HF-management in primary care improved adherence to pharmacological and non-pharmacological components of guideline-recommended care. Greater implementation of transitional care processes of this nature has the potential to improve clinical outcomes for patients with HF."}