Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: A real-world survey from India to understand the pattern of heart failure (HF) management (RISE)

The prevalence of heart failure (HF) in India is around 1% of the total population,1 whereas globally, it is around 1–2%, increasing to ≥ 10% among patients aged > 70 years.2 Currently, the incidence of HF in India is not clear, and has been estimated to be anywhere between 1.3 and 23 million.

As per the data published in the Trivandrum Heart Failure Registry (THFR), HF with preserved ejection fraction represents 25% of the total HF burden, which indicates that HF with reduced ejection fraction (HFrEF) is more predominant.

The profile and characteristics of Indian patients with HF is different as compared to patients worldwide; they have younger age of onset, The Trivandrum HF registry (THFR)1 enrolled 1205 admissions for HF (834 men, 69%). The mean age was 61.2 years. The most common etiology of HF was ischemic heart disease (72%). HF with preserved ejection fraction (HFpEF) constituted 26%. Patients with HF in the Trivandrum HF registry were younger, and had a higher prevalence of CAD.

It has been estimated that post-hospitalization events such as death and re-admission are 27.3% among patients with HF in India.5 Among Indian patients, adherence to medication ranges from 25% to 50%, and compliance to guideline-directed medical therapy (GDMT) is low.

In Indian patients, the prognosis of HF is very poor. As per the THFR data, the in-hospital mortality rate reported was 8.4% as compared to 4% in the ADHERE of USA. The INTER-CHF study also reported a mortality rate of 37% in Indian patients.

High readmission and mortality rates in HF need to be reduced with focus on the reasons for readmission and how to prevent these. Factors leading to higher readmission rates and mortality in India as per literature are lack of GDMT, poor education, lack of adherence to guidelines, poor treatment compliance, older age, New York Heart Association (NYHA) functional class IV status, and increased serum creatinine.

The purpose of this survey is to understand the current perceptions about managing heart failure, and underlying need gaps driving clinical inertia in implementation of guideline directed medical therapy and also help to address the current need gaps to look at potential interventions at patient level.

If you agree to participate, you will need to provide assessment response, on to the standard questionnaire form. A link will be provided for the same on your registered email address.

We trust you and we are partners in safe and effective drug therapy. In that spirit we hope you will consent to participate in this survey.

If you agree to participate in the said study, we would request you to sign and return the enclosed reply along with your visiting card for accuracy of records.