Background: Guideline directed medical therapy (GDMT) is the cornerstone of reducing mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF); however, uniform prescribing remains low. There is potential for multidisciplinary care teams, including pharmacists, to improve GDMT use in outpatient care for patients with HFrEF. Investigation is needed to understand the impact of pharmacists in outpatient HFrEF care on GDMT prescribing.
Objectives: To examine the impact of integrating a pharmacist into an outpatient cardiology setting on GDMT prescription rates during HFrEF-related clinic visits.
Methods: This retrospective chart review study examined cardiology clinic visits (HF clinic, “general cardiology” clinic, and pharmacist-only visits) before and after integration of pharmacists in the clinic. Visits were included for HFrEF patients (EF < 40%) from January 1, 2018 to July 1, 2019.
Results:Pharmacist visits had a significantly higher rate of GDMT compliance and significantly lower rate of harmful medication prescriptions than general cardiology visits (p
Conclusions: Integrating a pharmacist in the outpatient HFrEF care team can improve GDMT prescribing. Efforts should focus on workflow to optimize the role of the pharmacist in the clinic, and improving quality of data entry, such as standardized documentation of GDMT exceptions.
Robertson, Roy MD; Flanagan, Mindy PhD; Howard, Kris PharmD; Meisberger, Elizabeth PharmD; Keltner, Emily BS, MA; Singh, Lovekirat MS; Daley, Carly PhD; Wagner, Shauna BSN, RN; Toscos, Tammy PhD; and Mirro, Michael MD, FACC, FHRS, FAHA, "Integrating Pharmacists in HFrEF Outpatient Care to Improve Use of Guideline-Directed Medical Therapy" (2022). Health Services and Informatics Research. 59.