Faculty Articles
Evaluation of Pharmacist Impact Within an Interdisciplinary Inpatient Heart Failure Consult Service
Publication Title
The Annals of Pharmacotherapy
Publisher
Sage Publications Ltd.
ISSN
1542-6270
Publication Date
9-1-2019
Keywords
heart failure, interdisciplinary, pharmacy consult, veteran
Abstract
Background: Heart failure (HF) is highly prevalent in the Veterans Affairs (VA) health care system and the leading cause of hospital discharges in the VA. Despite guideline-specific recommendations of drug therapy, many patients are not on optimal medication regimens. Objective: To examine and quantify pharmacist impact in an interdisciplinary HF consult (IC) service on increasing use of guideline-directed medical therapy (GDMT). The 30-day readmission rates before and after the implementation of an IC service are reported. Methods: This was a single-center retrospective analysis of veterans admitted with a HF diagnosis between August 2008 and August 2015 in 2 distinctive cohorts: pre-IC (August 2008 to November 2011) and IC (November 2011 to August 2015). Results: Four-hundred patients were included, with 200 in each cohort. All-cause readmissions at 30 days were not different between pre-IC and IC groups: 33.5% versus 28.5%, respectively. Secondary outcomes of HF readmission and 1-year mortality were not different between groups. Significant increases in medication use rates were observed from admission to discharge in both cohorts; however, greater increases were observed in the IC group in which the pharmacist role was clearly defined in recommending GDMT optimization, especially in patients with HF with reduced ejection fraction. Conclusion and Relevance: Although the implementation of an IC service did not significantly change 30-day readmission rates, increases in GDMT use are evident with increased pharmacist involvement. Longer-term outcomes associated with this intervention warrant future investigation.
DOI
10.1177/1060028019842656
Volume
53
Issue
9
First Page
905
Last Page
915
Disciplines
Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences
NSUWorks Citation
Blizzard, Shannon; Verbosky, Natalie; Stein, Bradley; Hale, Genevieve; Patel, Nitin; Chau, Yen; and Cave, Brandon, "Evaluation of Pharmacist Impact Within an Interdisciplinary Inpatient Heart Failure Consult Service" (2019). Faculty Articles. 35.
https://nsuworks.nova.edu/hpd_corx_facarticles/35
