Pandemic pivot: Integrating virtual care into a nurse practitioner and clinical pharmacist–led heart failure medication titration clinic

Background Optimisation of heart failure guideline-directed pharmacotherapy improves clinical outcomes for individuals with heart failure. The coronavirus disease 2019 pandemic placed restrictions on in-person services and accelerated the adoption of virtual healthcare delivery, prompting re-examination of how advanced nursing practice can support patients requiring ongoing heart failure medication optimisation. Integrating virtual care into nurse practitioner–led services offers a scalable approach to medication titration while maintaining clinical safety and patient engagement. Aim To examine the outcome of heart failure medication optimisation via virtual healthcare delivery from a nurse practitioner and clinical pharmacist–led medication titration clinic during the COVID-19 pandemic. Methods A single-centre prospective observational cohort study was conducted in a heart failure nurse practitioner and clinical pharmacist–led titration clinic between April 2020 and April 2021 at The Prince Charles Hospital, Brisbane, Australia [blinded for review]. Primary outcome data included heart failure guideline-directed pharmacotherapy doses at baseline and study end, as well as clinical and demographic data. Secondary outcomes included hospital admission and mortality rates at 30 days and 6 months post-discharge from the clinic. Findings A total of 118 patients were included; 92 (78%) were male, with a mean age of 62 years (SD 14.4). Heart failure medication titration facilitated through virtual care significantly increased doses of guideline-directed medical therapy ( p < 0.001). Conclusion Integrating virtual care into a nurse practitioner and clinical pharmacist–led titration clinic was associated with meaningful optimisation of heart failure pharmacotherapy in a real-world setting.