Evidence map›Paper›PMID 41235598›Full record

ArticleThe Annals of pharmacotherapy2026

Assessment of Guideline-Directed Medical Therapy Optimization Scores and Readmission Risk in Heart Failure With Reduced Ejection Fraction.

Hanna Jensen, Max Staskauskas, Sara Strome, Jethro Pobre, Nghi Le, Cameryn Nakamura, Mina Fahmy, Benjamin Dang, Yvette Hellier, Jaekyu Shin and 7 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Annals of pharmacotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Hanna JensenDepartment of Pharmacy, UC San Diego Health, San Diego, CA, USA.
Max StaskauskasDepartment of Pharmacy, UC San Diego Health, San Diego, CA, USA.
Sara StromeDepartment of Pharmacy, UC San Diego Health, San Diego, CA, USA.
Jethro PobreUC San Francisco Health, San Francisco, CA, USA.
Nghi LeUC Davis Medical Center, Sacramento, CA, USA.
Cameryn NakamuraUC Davis Medical Center, Sacramento, CA, USA.
Mina FahmyRonald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Benjamin DangRonald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Yvette HellierUC San Francisco Health, San Francisco, CA, USA.
Jaekyu ShinSan Francisco School of Pharmacy, University of California, San Francisco, CA, USA.
Tiffany K PonUC Davis Medical Center, Sacramento, CA, USA.
Trina HuynhDepartment of Pharmacy, UC San Diego Health, San Diego, CA, USA.
Jennifer NambaSkaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
Louise T WangRonald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Christine CadizIrvine School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, USA.
Zaid YousifSkaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
Andrew WillefordSkaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-2146-3624

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeart failure with reduced ejection fraction carries high morbidity and mortality. Guideline-directed medical therapy (GDMT) improves outcomes, yet real-world use is often suboptimal. Multiple scoring tools quantifying GDMT optimization have been developed to identify areas of improvement, including GDMT count, Optimal Medical Therapy (OMT), modified OMT (mOMT), and Kansas City Medical Optimization (KCMO) scores. Their clinical utility in predicting readmissions is uncertain.

objectiveTo evaluate the association between four GDMT scoring systems and 30- and 90-day heart failure (HF) readmissions.

methodsThis multi-center, retrospective cohort study included adults with a left-ventricular ejection fraction ≤40% hospitalized for HF across five academic medical centers between February 2021 and July 2023. Patients discharged on ≥1 GDMT class with ≥1 healthcare encounter within 90 days were included. GDMT scores were calculated at discharge, and their associations with 30- and 90-day HF readmissions were analyzed using mixed-effects Cox proportional hazards models adjusted for clinical covariates.

resultsAmong 544 patients, 13.1% experienced 30-day and 26.8% experienced 90-day HF readmissions. At 30 days, no GDMT score was significantly associated with readmission. At 90 days, higher OMT (hazard ratios [HR]: 0.93, 95% CI: 0.86-0.99) and mOMT (HR: 0.94, 95% CI: 0.88-0.99) scores were associated with lower readmission risk, whereas GDMT count and KCMO scores were not. Patients on minimal GDMT regimens contributed disproportionately to 90-day readmissions. CONCLUSION AND RELEVANCE: In this multi-center cohort, OMT and mOMT scores, but not GDMT count or KCMO, were associated with 90-day HF readmissions. Findings highlight the potential utility of simpler GDMT scoring systems while underscoring the need for refined tools incorporating dose intensity, class-specific weighting, and longitudinal therapy to better guide optimization efforts.

Indexed as

Heart FailurePatient ReadmissionStroke VolumeAgedAged, 80 and overFemaleHumansMaleMiddle AgedPractice Guidelines as TopicRetrospective Studiesguideline-directed medical therapyheart failurehospital readmissionscore

Identifiers

PMID41235598
PMCPMC13172379

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.