What question did this study set out to answer?

To evaluate the effectiveness of a prescribing pharmacist-led heart failure clinic in optimizing guideline-directed medical therapies for patients with heart failure with reduced ejection fraction.

October 1, 2022European Heart Journal

Evaluation of a prescribing pharmacist-led heart failure (HF) up-titration clinic

View Full Paper

Ask AI

Bookmark

Why the study?

Patients with HFrEF are often sub-optimally dosed and experience prolonged optimisation of guideline-directed medical therapies.

Does a pharmacist-led heart failure clinic improve the uptake of guideline-directed medical therapy and surrogate markers in patients with HFrEF?

Population

76 patients with HFrEF attending a pharmacist-led clinic

Comparison

Post-optimisation vs baseline GDMT

Design

Single-centre cohort study

Authors

RWRhys WilliamsRoyal Marsden NHS Foundation Trust RDR. J. DonaldPrincess of Wales Hospital AJAnthony JamesMedical Council of Canada

Discussion

Member takes

Implication

Pharmacist-led clinics may boost quadruple GDMT and surrogates in HFrEF; supports hypothesis-generating evidence but leaves open need for RCTs.

Key Points

To evaluate the effectiveness of a prescribing pharmacist-led heart failure clinic in optimizing guideline-directed medical therapies for patients with heart failure with reduced ejection fraction.
Analyzed 76 patients with heart failure with reduced ejection fraction attending a prescribing pharmacist-led clinic across 318 consultations (34% virtual) between November 2020 and November 2021.
Tracked guideline-directed medical therapy uptake, left ventricular ejection fraction, NT-proBNP levels, vital signs, hospitalizations, and mortality from baseline through post-optimization.
Quadruple therapy uptake increased from 15% at baseline to 67% post-optimization, with post-treatment rates reaching 100% for ACEi/ARB/ARNI, 93% for MRAs, 90% for SGLT2 inhibitors, and 77% for beta-blockers.
Mean left ventricular ejection fraction improved from 32% to 42% and mean NT-proBNP decreased from 3,078 ng/L to 1,695 ng/L, with no significant alterations in renal function, blood pressure, or potassium.
During the study period, heart failure hospitalizations occurred in 11% of patients, other cardiovascular hospitalizations in 6%, and all-cause mortality was 7%.

Structured PICO

Does a pharmacist-led heart failure clinic improve the uptake of guideline-directed medical therapy and surrogate markers in patients with HFrEF?

Population

76 patients with heart failure with reduced ejection fraction (HFrEF) attending a pharmacist-led clinic, mean age 71 years, 36% female.

Intervention

Pharmacist-led heart failure up-titration clinic (averaging 4 consultations per patient, 34% virtual).

Outcome

Uptake of guideline-directed medical therapies (GDMT) and changes in LVEF and NT-proBNP post-optimization.surrogate

A pharmacist-led heart failure clinic significantly increased the proportion of HFrEF patients on quadruple guideline-directed medical therapy and improved LVEF and NT-proBNP.

Cite This Study

Williams et al. (2022) studied this question.

synapsesocial.com/papers/6a84f57a5d33534bf2de05a8 https://doi.org/10.1093/eurheartj/ehac544.1035

View Full Paper

Ask AI

Bookmark

Implication

Pharmacist-led clinics may boost quadruple GDMT and surrogates in HFrEF; supports hypothesis-generating evidence but leaves open need for RCTs.

Evaluation of a prescribing pharmacist-led heart failure (HF) up-titration clinic

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Evaluation of a prescribing pharmacist-led heart failure (HF) up-titration clinic

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider