protocolSection identificationModule nctId: NCT06386042, orgStudyIdInfo id: MEC-2022-0252, briefTitle: Guideline Implementation and Quality of Care in Patients With Heart Failure: the TITRATE-HF Registry, acronym: TITRATE-HF, statusModule overallStatus: ACTIVE_NOT_RECRUITING, startDateStruct date: 2022-06-05, primaryCompletionDateStruct date: 2029-02-14, completionDateStruct date: 2029-04, studyFirstPostDateStruct date: 2024-04-26, lastUpdatePostDateStruct date: 2024-04-26, sponsorCollaboratorsModule leadSponsor name: Erasmus Medical Center, class: OTHER, collaborators name: Netherlands Heart Institute, descriptionModule briefSummary: SUMMARY Rationale: Quality of Care registries provide valuable insight in guideline adherence and implementation of guideline recommendations in routine clinical practice.Objective: The overall aim of the project is to study the titration of guideline directed medical therapy (GDMT) according to the European Society of Cardiology (ESC) HF 2021 guideline recommendations for patients with heart failure (HF) reduced ejection fraction (HFrEF), and mildly reduced ejection fraction (HFmrEF).Study design: The current study is a prospective multi-center national quality of care registry (longitudinal) of regular HF care (as given).Study population: The study population consists of patients with heart failure (de novo HF, chronic HF and worsening HF). Study setting is outpatient or inpatient (during admission). Patient sample is set at a minimum of 4000 patients, but can be expanded during the course of the registry project.Participating sites: all hospitals with dedicated HF outpatient clinic in the Netherlands can participate.Data: aggregated dataIntervention: none / noMain study parameters/endpoints: The main parameters of quality of HF care are the adherence to guideline recommendation in terms of percentage (%) drug prescription, percentage (%) target dose (order, speed) and reason not to adhere to the guideline (intolerance, side-effects, maximum tolerated dose). The main endpoints for prognosis are the number of HF related hospitalizations and all-cause mortality during follow-up.Nature and extent of the burden and risks associated with participation, benefit and group relatedness: There is no risk in participation, no intervention and no active involvement of patients for specific activities in the study. The project is a registration of care as given (standard care) to the participating subject with heart failure., conditionsModule conditions: Heart Failure, designModule studyType: OBSERVATIONAL, designInfo observationalModel: COHORT, timePerspective: PROSPECTIVE, enrollmentInfo count: 4289, type: ESTIMATED, armsInterventionsModule interventions name: no intervention, observational study, outcomesModule primaryOutcomes measure: Prescription level (percentage,%) and target dose (percentage, %) of guideline-directed medical therapy for HF, secondaryOutcomes measure: All-cause mortality, secondaryOutcomes measure: Hospital admission due to heart failure related event and/or urgent visit with necessity of furosemide iv., secondaryOutcomes measure: Hospital admission due to non heart failure related event, eligibilityModule sex: ALL, minimumAge: 18 Years, stdAges: ADULT, stdAges: OLDER_ADULT, contactsLocationsModule locations facility: Erasmus MC, city: Rotterdam, state: Zuid-Holland, zip: 3015CE, country: Netherlands, geoPoint lat: 51.9225, lon: 4.47917, hasResults: False