Aim:To determine the impact of a pharmacist intervention on patient-guided diuretic dose adjustment in ambulatory patients with heart failure. Method: Patients with heart failure were randomised to usual care or usual care plus pharmacist intervention and followed for 3 months. Pharmacist intervention focused on patients improving self-care, recognising symptoms of fluid retention, measuring weight daily and self-adjusting diuretic dose using frusemide. The primary outcome was the number of appropriate weight-titrated frusemide dose adjustments. Secondary outcomes included the number of patients who correctly selfadjusted their frusemide dose, hospital readmissions due to fluid overload, heart failure-related knowledge and understanding, and quality of life (using validated tools). Results: 70 patients were recruited: 35 usual care (control) and 35 usual care plus pharmacist intervention. The average number of appropriate weight-titrated frusemide dose adjustments per patient per month in the control group was 0.32 ± 0.08 and in the intervention group was 0.85 ± 0.13 (p = 0.006). Hospital readmissions due to fluid overload was 31% in the control and 14% in the intervention groups (p = 0.04). There were significant differences between the groups regarding appropriate self-adjusted frusemide doses, heart failure-related knowledge and understanding, and quality of life. Conclusion: A pharmacist intervention improved the ability of heart failure patients to self-adjust their diuretic dose by using a flexible dosing regimen based on weight, resulting in quality of life improvement and a decrease in hospital readmissions due to fluid overload.

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