# PATHFINDER-trial: betere naleving van hartfalenrichtlijnen in de huisartsenpraktijk

*geplaatst 2026-02-23 · Hartfalen · ESC heart failure · doi 10.1093/eschf/xvag061 · https://hartvaat.nl/2026/02/23/pathfinder-trial-betere-naleving-van-hartfalenrichtlijnen-in-de-huisartsenprakti/*

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.

## English: Primary care Adherence To Heart failure guidelines in post-Discharge, Evaluation & Routine management (PATHFINDER): a randomised controlled trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: ESC heart failure, https://doi.org/10.1093/eschf/xvag061. Bijgewerkt 2026-08-10T11:07:51Z. 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.