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NODE Survey Study: AdoptioN Of Guideline-Directed medical
thErapy (GDMT) and four pillar in the management of heart failure

Survey Questionnaire Form

Doctor’s details

Years of clinical practice *

Predominant type of practice *

Specialty *

Place of practice *

Questionnaire

  1. How many heart failure patients do you see every day? *

  2. What is the ratio of Diabetic & Non-diabetic heart failure patients in your practice? *

  3. What is the percentage of Heart Failure preserved Ejection Fraction (HFpEF) patients in your clinical practice? *

  4. What is the percentage of Heart Failure reduced Ejection Fraction (HFrEF) patients in your clinical practice? *

  5. In general, what is the frequency of hospital admission in the first year of diagnosis of heart failure in patients with HFpEF? *

  6. In general, what is the frequency of hospital admission in the first year of diagnosis of heart failure in patients with HFrEF? *

  7. What is most common presenting signs/symptoms observed in your patients? (Tick multiple-options, if applicable) *

  8. What are the key diagnostic methods for Heart failure? (Tick multiple-options, if applicable) *

  9. Which approach do you prefer most for your HF patient management? *

  10. According to you, immediately after diagnosis what percentage of heart failure (HF) patients may be receiving 4 drugs [beta blockers (BB), antagonists of the renin-angiotensin system (RAAS) (angiotensin converting enzyme inhibitors; ACEi; angiotensin receptor antagonists; ARB; angiotensin receptor neprilysin inhibitors; ARNI) and mineralocorticoid receptor antagonists (MRAs)] together? *

  11. How early would you prefer initiating the 4 drugs (ACEi/ARB or ARNI, Beta-blocker, MRA, SGLT2i) in your HFrEF patients? *

  12. In clinical practice, do you feel that majority of patients with heart failure with reduced ejection fraction (HFrEF) are not receiving one or more of the recommended medications? *

  13. Do you agree with the observation that, early initiation of a combination of angiotensin receptor blockers/neprilysin inhibitors (ARNIs), betablockers, mineralocorticoid receptor agonists (MRAs), and SGLT2i may improve life expectancy in HFrEF by a median of 6 years compared with more limited regimens? *

  14. According to you, what are the challenges in optimizing multiple therapies in heart failure patients? *

  15. According to you, early initiation of Guideline Directed Medical Therapy (GDMT) offers (More than one option can be selected) *

  16. Give your opinion on usage of GDMT helps in reducing heart failure hospitalization, mortality, and improves the functional capacity *

  17. According to you, in which clinical scenarios GDMT can initiated early? (More than one option can be selected) *

  18. What are the potential side effects with use of GDMT together (ARNI, Beta Blocker, MRA & SGLT2i)? (More than one option can be selected) *

  19. Do you believe initiating GDMT is beneficial in hospitalized HF patients who are stable? *

  20. Which are major challenges in terms of initiating GDMT in elderly or frail patients *

  21. In heart failure patients with chronic kidney disease (CKD) with hyperkalemia and hypotension, SGLT2 inhibitor should be preferred above ARNI? *

  22. Abnormal renal function and/or hyperkalemia are common barriers to initiation and titration of guideline-directed medical therapy (GDMT) *

  23. What percentage of patients treated for HFrEF are started on drugs quickly and up-titrated rapidly from your perception? *

  24. Kindly opine on “Sodium-glucose cotransporter-2 inhibitor therapy is well suited for initiation during the heart failure hospitalization, owing to clinical benefits such as minimal to no effects on blood pressure, and no excess risk of adverse kidney events” *

  25. What % of your patients are on target dose of MRAs? *

  26. In what percentage of HFrEF & HFpEF patients with diabetes you recommend SGLT2i? *

  27. What % of your patients are on target dose of ARNI and beta-blockers? *

  28. How frequently do you recommend NT-proBNP post-initiation of HF therapy? *

  29. What % of HF patients receiving SGLT2 inhibitors are non-diabetic? *

  30. According to you what are the reasons for guideline-recommended medical therapy (GDMT) being underutilized? (More than one option can be selected) *