Bridging the gap between guidelines and clinical practice: the use of an online multidisciplinary heart failure care pathway in Belgium and beyond
D Derthoo, D Vervloet, A Roussoulieres, P Nijst, M Dupont, A C Pouleur, P Troisfontaines, P H TimmermansAbstract
Introduction
Implementation of international heart failure (HF) guidelines is known to remain challenging in practice. HF patients should be able to monitor themselves. They are treated by cardiologists but also by general practitioners, other specialists, nurses, and others. Their knowledge and experience with HF and the most recent guidelines are often inadequate or outdated. This can lead to inappropriate diagnostic and therapeutic interventions.
Objective
To bridge the gap between the guidelines and the real world practice, the Belgian Working Group on Heart Failure (BWGHF) developed a practical translation of the ESC guidelines into an online detailed HF care pathway with practical information and advice regarding treatment and follow-up for all involved healthcare providers and patients. By better educating everyone and streamlining follow-up, the treatment of patients and ultimately their prognosis should improve. One year after the launch, we wanted to evaluate the use of this care pathway, both nationally and beyond.
Methods
The HF care pathway is based on the latest ESC guidelines and expert opinions of the BWGHF members. To improve accessibility and adaptability, it was developed into an interactive website in Dutch, French and English. From the homepage the desired information can be quickly found. The website (1) is online since November 2024. After a launch event, publicity was made on LinkedIn, national health care related websites, Belgian medical journals for GPs, and local presentations given by BWGHF members for various healthcare providers in Belgium. It was advised to use the reference to the care path in medical reports and patient diaries. One year later, indices on website use such as total visits, nationality of visitors and bounce rates were evaluated.
Results
In 2025 the website has been visited 32484 times. In January 2025 there were 1887 visitors (average 60,9 ± 20,6 per day). This number increased in December 2025 to 8375 visitors (average 270,2 ± 104,1 per day). The website was launched in Belgium but is used worldwide. In January 2025, visitors came from 36 different countries, in December 2025 from 146 countries. The countries where the website was most used in January 2025 were Belgium (79.8%), the Netherlands (5.1%), the USA (4.1%), France (3%). By December 2025, these were France (30.8%), Belgium (23.5%), the Netherlands (12.1%), Singapore (5.5%), and the USA (4.9%). Overall, the bounce rate of the home page was 34 - 37%.
Conclusion
An online multidisciplinary, all-encompassing heart failure care pathway (1) was launched in Belgium. During 2025 the use of the website increased in Belgium and worldwide. This reflects an unmet need for clinicians, paramedics, patients and their families for ready-to-use information on heart failure all over the world. This platform has the potential to reach all involved in heart failure care to improve heart failure management in daily practice globally.Evolution of the number of visitorsFor image description, please refer to the figure legend and surrounding text.Evolution of the global useFor image description, please refer to the figure legend and surrounding text.