A pharmacist intervention significantly increased the average number of appropriate weight-titrated frusemide dose adjustments per patient per month compared to usual care (0.85 vs 0.32; p=0.006).
RCT (n=70)
randomised
Does a pharmacist intervention improve appropriate weight-titrated frusemide dose adjustments in ambulatory patients with heart failure?
A pharmacist-led intervention significantly improved heart failure patients' ability to self-adjust diuretic doses, leading to improved quality of life and fewer hospital readmissions for fluid overload.
Absolute Event Rate: 0.85% vs 0.32%
p-value: p=0.006
ABSTRACT Aim To determine the impact of a pharmacist intervention on patient–guided diuretic dose adjustment in ambulatory patients with heart failure. Method Patients with heart failure were randomised to usual care or usual care plus pharmacist intervention and followed for 3 months. Pharmacist intervention focused on patients improving self‐care, recognising symptoms of fluid retention, measuring weight daily and self‐adjusting diuretic dose using frusemide. The primary outcome was the number of appropriate weight‐titrated frusemide dose adjustments. Secondary outcomes included the number of patients who correctly self‐adjusted their frusemide dose, hospital readmissions due to fluid overload, heart failure‐related knowledge and understanding, and quality of life (using validated tools). Results 70 patients were recruited: 35 usual care (control) and 35 usual care plus pharmacist intervention. The average number of appropriate weight‐titrated frusemide dose adjustments per patient per month in the control group was 0.32 ± 0.08 and in the intervention group was 0.85 ± 0.13 (p = 0.006). Hospital readmissions due to fluid overload was 31% in the control and 14% in the intervention groups (p = 0.04). There were significant differences between the groups regarding appropriate self‐adjusted frusemide doses, heart failure‐related knowledge and understanding, and quality of life. Conclusion A pharmacist intervention improved the ability of heart failure patients to self‐adjust their diuretic dose by using a flexible dosing regimen based on weight, resulting in quality of life improvement and a decrease in hospital readmissions due to fluid overload.
Korajkic et al. (Wed,) conducted a rct in heart failure (n=70). Pharmacist intervention (self-care, symptom recognition, daily weight, self-adjusting frusemide) vs. Usual care was evaluated on Number of appropriate weight-titrated frusemide dose adjustments per patient per month (p=0.006). A pharmacist intervention significantly increased the average number of appropriate weight-titrated frusemide dose adjustments per patient per month compared to usual care (0.85 vs 0.32; p=0.006).