The presentation starts with the objectives of the ESC guideline, and an overview of the current situation in UK for patients discharges with HFrEF.

In this real-world setting, greater optimization of guideline-directed therapies is associated with better outcomes. HF therapies are often not optimized before, but after worsening events:

• Heart failure care remains sub-optimal for MANY patients; drug dosage is low and remains low.
• Hospitalization is a key opportunity to optimize therapy and help educate patients and their families.

For the optimization of therapy, Martin Cowie shows a program to improve patient outcomes both during and after hospitalization, with 3 specific steps.

In this context he presents the PRIME_HF study: ivabradine initiation prior to discharge among stabilized HF patients increased ivabradine use at 6 months follow-up.

He also speaks about obstacles to implementation of the optimize heart failure care program and factors associated with effective implementation of the optimize heart failure care program:

• Every contact must be used after hospitalization
• A local champion is essential, leading the team
• Success does not come overnight – try and try again