BackgroundHigh heart failure (HF) re-hospitalization rate is a great challenge for patients, physicians and a health care system. This study aimed to analyze the impact of physicians’ and patients’ adherence to guideline-recommended therapy on HF re-hospitalizations in patients hospitalized due to worsening HF.MethodsThis analysis included data from an international prospective multicenter Optimize Heart Failure Care program collected over 12 months from 635 patients hospitalized with worsening HF. To assess physician’s adherence to guideline-recommended doses of HF medications we used a five-class guideline adherence score. Three types of adherence were definedgood adherence (use of all guideline-recommended HF medications); moderate adherence (use of more than half of recommended medications); poor adherence (use of guideline-recommended ≤50% medications). To assess patient’s adherence to recommended medications we used the indirect method (patient-reported compliance, which was measured by using study special questionnaire). Three types of adherence were determinedgood (always took all prescribed medications at target doses), moderate (sometimes patients didn’t take one class of medications or took them at suboptimal doses) and poor adherence (patients didn’t take all the prescribed medications).ResultsThe baseline global adherence score was good in 35%, moderate in 63%, and poor in 2% of HF patients. In the group of good physician’s adherence to guideline-recommended therapy 114 patients (51%) had a good adherence, 95 patients (42%) - moderate adherence and only 15 patients (7%) had poor adherence. In the group of moderate physician’s adherence only 88 patients (22%) took medications as prescribed, 266 patients (66%) demonstrated moderate compliance and 44 patients (12%) didn’t take all prescribed medications. After 12 months of follow-up the rates of HF re-hospitalizations were significantly higher in the groups of various physicians’ adherence, when patients’ adherence was poor (HR 2.34, 95% CI 1.46-3.27, p=0.0001).ConclusionDespite the type of physicians’ adherence, patients with poor adherence to guideline-recommended therapy demonstrated higher rates of HF re-hospitalizations. New educational initiatives for both physicians and patients are required to optimize HF treatment.