The impact of a heart failure management protocol based on a hospital-community pharmacist collaboration

BACKGROUND: Heart failure has a high readmission rate, but interventions by multiple professionals are effective. Although there is growing interest in the management of heart failure by community pharmacists in Japan, no effective method has been developed. We created and verified the effectiveness of a novel heart failure management protocol that community pharmacists could utilize. METHODS: This study included 68 patients (80.8 ± 11.8 years; male, 60.3%) diagnosed with heart failure who was admitted to our hospital between March 2022 and September 2023. A protocol was developed for the regular follow-up of patients and responses to exacerbations, in collaboration with pharmacists. Patients who were able to receive follow-up from community pharmacists were included in the intervention group, otherwise they were included in the control group. The primary endpoint was readmission, and the secondary endpoint was a composite of readmission, all-cause death, hospitalization, and dialysis due to dehydration or renal dysfunction. RESULTS: The Kaplan-Meier analysis (p = 0.021) and Cox model (hazard ratio: 0.28, 95% confidence interval: 0.09-0.89, p = 0.031) revealed a significantly lower incidence of heart failure readmission within 360 days in the intervention group than in the control group. CONCLUSIONS: The implementation of a heart failure management protocol that provides clear guidance on appropriate patient management enabled pharmacists to effectively reduce the likelihood of adverse events, such as heart failure readmission. THE REGISTRATION NUMBER: UMIN000046750, registered on February 1, 2022.