Implementing Clinical Decision Support Tools and Pharmacovigilance to Reduce the Use of Potentially Harmful Medications and Health Care Costs in Adults With Heart Failure

Abstract

Heart failure (HF) is associated with significant morbidity, mortality, compromised quality of life and socioeconomic burden worldwide. This chronic condition is becoming an increasingly important concern given the increased prevalence of HF among aging populations. Significant contributors toward escalating health care costs are emergency room visits and hospitalizations associated with HF. An important strategy to improve health care outcomes and reduce unnecessary costs is to identify and reduce the prescribing of potentially harmful medications (PHMs) among adults with HF. Previous studies in patients with HF found roughly 10–50% of them were prescribed at least one PHM in ambulatory care and inpatient health care settings. This opinion highlights recent findings from studies assessing prevalence of PHMs, associations between PHM prescribing and characteristics, and what can be done to improve patient outcomes and reduce the use of PHMs and associated health care costs in adults with HF.

Clinical Decision Support Tools for Optimizing Guideline-Directed Medical Therapy for Heart Failure

“…One relatively naïve area of investigation is the development of clinical decision support (CDS) tools specifically for GDMT optimization. Literature of CDS tools in HF is limited with only 2 recent studies targeting greater use of GDMT, 8 , 9 , 10 while others focused on selecting patients for advanced HF therapies 11 and diagnosis in primary care. 12 Application of CDS for cardiovascular disease in general has been limited and with variable success.…”