INTRODUCTION<p style="text-align: justify;" data-mce-style="text-align: justify;">Heart failure (HF) is a common cause of hospitalization, heart failure-related readmission, poor quality of life, and mortality. It also poses a substantial economic burden. The heart failure clinical practice guideline (HFCPG) was developed to provide evidence-based recommendations on the diagnosis and management of chronic HF with reduced ejection fraction (HFrEF) among adult Filipino patients in the outpatient setting for primary care physicians.p>METHODS<p style="text-align: justify;" data-mce-style="text-align: justify;">The GRADE approach and an Evidence-to-Decision framework were used to evaluate the evidence and formulate recommendations. The strength and direction of each recommendation were determined through voting, with consensus reached if 75% of all CP members agreed.p>RESULTS<p style="text-align: justify;" data-mce-style="text-align: justify;">The HFCPG provides 19 recommendations and one good practice statement in response to 14 identified clinical questions. Careful history-taking and physical examination, use of chest x-ray to detect cardiomegaly and/or pulmonary congestion, two-dimensional echocardiography for HF diagnosis, and baseline determination of serum sodium, potassium, and creatinine to guide management have been highly recommended; however, the 12-lead electrocardiogram should not be solely used for HF diagnosis. Judicious use of diuretics to relieve congestion, use of selected beta-blockers, renin-angiotensin-aldosterone blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors are strongly recommended for the treatment of HFrEF.p>CONCLUSION<p style="text-align: justify;" data-mce-style="text-align: justify;">HFrEF is a complex condition that requires early recognition and careful management. Guideline-directed medical therapies, particularly the evidence-based pillars of treatment, are recommended, as well as early discussion of palliative care, timely determination of advanced heart failure and the need for referral to higher levels of care.p>
Human ; Heart Failure ; Outpatient Care ; Ambulatory Care ; Primary Health Care

INTRODUCTION<p>Heart failure (HF) remains a significant global health issue, affecting approximately 64 million individuals worldwide. In the Philippines, the prevalence aligns with global estimates, disproportionately affecting older populations.p>METHODOLOGY<p>The Philippine National Heart Failure Network (PNHFN) conducted a cross-sectional survey from November 2021 to March 2022 to assess the landscape of HF management among medical professionals across the country.p>RESULTS<p>A total of 1,649 physicians responded, primarily cardiologists (64%), internal medicine specialists (27%), and general practitioners (12%). While diagnostic tools such as electrocardiography (92%) and 2D echocardiography (85%) were widely available, advanced imaging modalities and specialized cardiac procedures, including cardiac catheterization and heart failure implantable devices, were less accessible outside metropolitan areas. Essential HF medications, including renin-angiotensin system blockers (84%), beta-blockers, and diuretics, were commonly prescribed; however, newer pharmacologic options such as sodium-glucose co-transporter 2 inhibitors remained underutilized.p>CONCLUSION<p>Cardiac rehabilitation was accessible to less than half of respondents (48%), with unavailability cited as a major barrier. Despite these challenges, 97% of participants supported the establishment of HF programs to improve patient care and provider support. The findings highlight the need for improved access to advanced diagnostic and therapeutic modalities, enhanced education on guideline-directed HF management, and expanded infrastructure to bridge gaps in care delivery. Strengthening national HF initiatives and fostering collaboration among stakeholders are crucial in optimizing HF management and patient outcomes in the Philippines.p>
Human ; Heart Failure ; Philippines ; Healthcare Infrastructure ; Public Health Infrastructure