Addition of Pharmacist versus Usual Care Impact on Heart Failure with Reduced Ejection Fraction Management in a Cardiology Clinic
by Brooke Foster, PharmD, Kristina Cha-Vang, PharmD, Zachary Pape, PharmD, BCACP, Erin Wilkes, PharmD, BCPS
"Objectives: Well-studied heart failure with a reduced ejection fraction (HFrEF) medications reduce morbidity and mortality when titrated to evidence-based target or maximally tolerated doses. External studies showed benefits when pharmacists manage HFrEF medications, but internal validation at Froedtert & the Medical College of Wisconsin (F&MCW) had not been done. This study aimed to describe the differences in HFrEF medication-related management between patients who were and were not followed by a pharmacist.
Methods: A retrospective chart review was conducted of patients who were followed by an F&MCW Cardiology Clinic provider and prescribed
a new HFrEF medication over a one-year period. Patients were stratified into the provider or pharmacist group and were compared based on reaching target or maximally tolerated doses for prescribed HFrEF medications; appropriate lab monitoring; number of visits; time between visits; number of heart failure admissions and re-admissions; and change in left ventricular ejection fraction (LVEF).
Results: Patients in the pharmacist group met their target or maximally tolerated doses at a higher rate than the provider group for four of seven HFrEF medications. There was no appreciable difference in appropriate lab monitoring. Patients in the pharmacist group had more visits and were seen more frequently. The pharmacist group saw a larger average LVEF increase and fewer admissions and re-admissions.
Conclusions: These results suggest that when pharmacists are included in a patient’s care team, the team provides superior, more efficient medication-related care to patients with HFrEF. Pharmacists can effectively titrate HFrEF medications because they are able to focus on a patient’s medications."
Keywords: Humans, Stroke Volume, Pharmacists, Heart Failure, Retrospective Studies, Maximum Tolerated Dose, Wisconsin, Ventricular Function, Left, Ventricular Dysfunction, Left, Hospitalization, Morbidity, Ambulatory Care Facilities, Cardiology
Download PDF
2021 May/June Table of Contents
"Objectives: Well-studied heart failure with a reduced ejection fraction (HFrEF) medications reduce morbidity and mortality when titrated to evidence-based target or maximally tolerated doses. External studies showed benefits when pharmacists manage HFrEF medications, but internal validation at Froedtert & the Medical College of Wisconsin (F&MCW) had not been done. This study aimed to describe the differences in HFrEF medication-related management between patients who were and were not followed by a pharmacist.
Methods: A retrospective chart review was conducted of patients who were followed by an F&MCW Cardiology Clinic provider and prescribed
a new HFrEF medication over a one-year period. Patients were stratified into the provider or pharmacist group and were compared based on reaching target or maximally tolerated doses for prescribed HFrEF medications; appropriate lab monitoring; number of visits; time between visits; number of heart failure admissions and re-admissions; and change in left ventricular ejection fraction (LVEF).
Results: Patients in the pharmacist group met their target or maximally tolerated doses at a higher rate than the provider group for four of seven HFrEF medications. There was no appreciable difference in appropriate lab monitoring. Patients in the pharmacist group had more visits and were seen more frequently. The pharmacist group saw a larger average LVEF increase and fewer admissions and re-admissions.
Conclusions: These results suggest that when pharmacists are included in a patient’s care team, the team provides superior, more efficient medication-related care to patients with HFrEF. Pharmacists can effectively titrate HFrEF medications because they are able to focus on a patient’s medications."
Keywords: Humans, Stroke Volume, Pharmacists, Heart Failure, Retrospective Studies, Maximum Tolerated Dose, Wisconsin, Ventricular Function, Left, Ventricular Dysfunction, Left, Hospitalization, Morbidity, Ambulatory Care Facilities, Cardiology
Download PDF
2021 May/June Table of Contents