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Physician–Pharmacist Team-Guided Therapeutic Optimization in Heart Failure

Guideline-directed medical therapy (GDMT) of patients with heart failure delivered virtually by physician-pharmacist teams was safe and improved GDMT across several hospitals in an integrated healthcare system, researchers report. “Virtual teams represent a centralized, scalable approach to optimize GDMT,” the group concludes.

Patients with LVEF≤40% who received a virtual care team-guided strategy (up to 1 daily GDMT optimization suggestion from a physician-pharmacist team) had these changes in a primary effectiveness outcome (in-hospital change in GDMT optimization score): “Among 252 encounters, mean age was 69 ± 14 years, 85 (34%) were women, 35 (14%) were Black, and 43 (17%) were Hispanic. The virtual care team strategy significantly improved GDMT scores vs. usual care (adjusted difference +1.2; 95% CI: 0.7-1.8; P <0.001). New initiations (44% vs. 23%; P =0.001) and intensifications of ≥1 GDMT (50% vs.28%; P = 0.001) were higher in the virtual care team group, translating to a number-needed-to-intervene of 5 encounters. Overall, 23 (21%) in virtual care team group and 40 (28%) in usual care experienced 1 or more safety events (P = 0.30). [Acute kidney injury], bradycardia, hypotension, and hyperkalemia were similar between groups.”

Source: Journal of the American College of Cardiology