Key result
Multidisciplinary Plan-Do-Study-Act intervention boosts discharge on ≥3 GDMT pillars to ~69% and reduces HF readmissions.
Why the study?
Many hospitalized HFrEF patients are discharged without optimal guideline-directed medical therapy due to cost barriers, deferred titration, and inconsistent education.
Does a multidisciplinary Plan-Do-Study-Act intervention improve discharge on ≥3 GDMT pillars and reduce readmissions in hospitalized HFrEF patients?
Does a multidisciplinary Plan-Do-Study-Act intervention improve discharge on ≥3 GDMT pillars and reduce readmissions in hospitalized HFrEF patients?
Absolute Event Rate: 69.4% vs 47.4%
p-value: p=0.006
A structured, pharmacy-supported GDMT workflow significantly improved the prescription of ≥3 GDMT pillars at discharge and reduced 30-day readmissions in hospitalized HFrEF patients.
Supports multidisciplinary QI protocols to boost GDMT discharge and reduce HF readmissions; extends single-center evidence but needs randomized confirmation.
BACKGROUND: Guideline-directed medical therapy (GDMT) reduces mortality and rehospitalization in heart failure with reduced ejection fraction (HFrEF), yet many hospitalized patients are discharged without optimal therapy. PROJECT RATIONALE: A baseline audit at our community teaching hospital showed fewer than half of eligible patients were discharged on ≥3 GDMT pillars, driven by cost barriers, deferred titration, and inconsistent education. PROJECT SUMMARY: A multidisciplinary Plan-Do-Study-Act intervention standardized GDMT workflows, incorporating pharmacist-led admission review, structured checklists, teach-back counseling, a meds-to-beds program, and early outpatient follow-up. Among 62 postintervention versus 152 baseline patients, discharge on ≥3 pillars increased from 47.4% to 69.4% (P = 0.006), heart failure-specific 30-day readmissions decreased from 23.7% to 9.7% (P = 0.022), and all-cause readmissions from 30.9% to 16.1% (P = 0.028). LIMITATIONS: Modest postintervention sample size warrants cautious interpretation. TAKE-HOME MESSAGE: Structured, pharmacy-supported GDMT workflows improved prescribing performance and reduced 30-day readmissions in HFrEF.
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Khan et al. (2026) studied Heart failure with reduced ejection fraction (HFrEF) (n=214). Multidisciplinary Plan-Do-Study-Act intervention vs. Baseline care was evaluated on Discharge on ≥3 GDMT pillars (p=0.006). A multidisciplinary Plan-Do-Study-Act intervention increased discharge on ≥3 GDMT pillars from 47.4% to 69.4% (P=0.006) and reduced heart failure-specific 30-day readmissions from 23.7% to 9.7%.
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