The Perfect Storm: Barriers to Heart Failure Treatment Optimization.

Despite advances in heart failure therapies with proven positive outcomes, treatment gaps in clinical practice persist and heart failure morbidity and mortality remain high. The lack of treatment intensification to evidence-based targets accounts for a significant portion of unattained treatment goals and has been characterized to involve 3 main elements: the provider initiating and titrating the medication(s), the patient themselves, and the system that serves as the gatekeeper and facilitator for health care needs. This article will examine the mechanisms and impact of these 3 factors, and present targeted initiatives to help improve patient outcomes and quality of care.