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Pharmacist-led intervention in the multidisciplinary team approach optimizes heart failure medication

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Abstract

We evaluated the impact of pharmacist-led heart failure (HF) drug recommendations during hospitalization for hospitalized patients with HF. Hospitalized patients with HF were retrospectively reviewed. Patients were hospitalized before (n = 208, non-intervention group) or after (n = 170, intervention group) the launch of the HF multidisciplinary team (HFMDT) approach with pharmacist-led HF medication optimization. There were no significant group differences in patient background characteristics at admission. Patients with HF with reduced ejection fraction who were not on beta blockers or angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACE-I/ARB) at admission were significantly more likely to be on beta blockers at the time of discharge in the intervention group (73.3 vs 96.3%, P = 0.027) compared to those in non-intervention group; however, the change in ACE-I/ARB prescriptions was not significant (53.3 vs 63.3%, P = 0.601). The proportion of patients on any drug with recommendations against its use in patients with HF did not change from admission to discharge in the non-intervention group (21.2 vs. 20.2%, P = 0.855), but was significantly reduced in the intervention group (22.9 vs. 12.9%, P = 0.005). There were no group differences in the in-hospital all-cause mortality (non-intervention, 3.4%; intervention, 2.4%; P = 0.761) or length of hospital stay (median: non-intervention, 13 days; intervention, 14 days; P = 0.508). Pharmacist-led HF drug recommendations during hospitalization as part of a HFMDT approach for hospitalized patients with HF can increase beta blocker prescriptions and decrease non-preferred drug prescriptions.

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Acknowledgements

We would like to thank Hitoshi Tanaka and Shota Tsuruoka for their aid in the acquisition of the clinical data.

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Correspondence to Yuya Matsue.

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No specific funding or support was received.

Conflict of interest

Yuya Matsue is supported by JSPS (Japan Society for the Promotion of Science) Overseas Research Fellowships, and received an honorarium from Otsuka Pharmaceutical Co. Makoto Suzuki received honorariums from Bayer Pharmaceutical Co., Otsuka Pharmaceutical Co., Nippon Boehringer Ingelheim Co., Ltd., St. Jude Medical, Fukuda Denshi Co., Ltd., and Medtronic Japan Co., Ltd. Other authors have nothing to disclose.

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Suzuki, M., Matsue, Y., Izumi, S. et al. Pharmacist-led intervention in the multidisciplinary team approach optimizes heart failure medication. Heart Vessels 33, 615–622 (2018). https://doi.org/10.1007/s00380-017-1099-8

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