Multifaceted strategies adapting existing multidisciplinary models of care are the most successful approaches to improve medication titration in patients with heart failure.
Multifaceted strategies that adapt multidisciplinary models of care and engage primary care are most successful in improving medication titration in heart failure.
Large-scale randomised controlled trials (RCTs) have demonstrated that angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and beta-blockers decrease mortality and hospitalisation in patients with heart failure (HF) associated with a reduced left ventricular ejection fraction. This has led to high prescription rates; however, these drugs are generally prescribed at much lower doses than the doses achieved in the RCTs. A number of strategies have been evaluated to improve medication titration in HF, including forced medication up-titration protocols, point-of-care decision support and extended scope of clinical practice for nurses and pharmacists. Most successful strategies have been multifaceted and have adapted existing multidisciplinary models of care. Furthermore, given the central role of general practitioners in long-term monitoring and care coordination in HF patients, these strategies should engage with primary care to facilitate the transition between the acute and primary healthcare sectors.
Atherton et al. (Sun,) conducted a editorial in Heart failure. Medication titration strategies was evaluated. Multifaceted strategies adapting existing multidisciplinary models of care are the most successful approaches to improve medication titration in patients with heart failure.
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