Real-world Management of Heart Failure in the Philippines: The HF ER Registry

Background: There have been several past registries of heart failure (HF) in the Philippines, but data on follow-up outpatient care after discharge were sparse. This study aimed to describe the characteristics, treatment patterns and outcomes of HF patients enrolled in a purely electronic HF registry. Methods: This HF registry is a pilot, non-interventional, longitudinal, multicentre registry of adult HF patients enrolled from three study sites. The HF registry used an electronic medical record application for data collection. Results: The three study sites enrolled 394 HF patients. The majority were male (72.34%) and the mean age was 56.91 ± 14.15 years. Only 75 patients (18.84%) had natriuretic peptide measurement. Regarding HF type, the majority had HF with reduced ejection fraction (EF) (41.12%) or HF with preserved EF (24.11%) while 22.59% had HF with mildly reduced EF; however, 12.18% were unclassified due to lack of echocardiography results. Overall, only 12.18% received four drug classes and 24.27% received three drug classes. Most patients (84.77%) had at least one follow-up visit. During follow-up, 6.60% of patients experienced acute decompensation and 20.81% were hospitalised. The mortality rate was 15.48%. The number of drug classes administered was associated with a lower risk of decompensation (p=0.030) or the composite of hospitalisation or death (p=0.001). Conclusion: This pilot HF registry showed that a purely electronic HF registry is implementable across various types of healthcare institutions. The majority of HF patients in the Philippines receive only suboptimal pharmacotherapy, which may contribute to high 12-month hospitalisation and mortality rates.