Management of heart failure patients through integrative medical group visits

Singrey, Amanda M.; Mehta, Bella H.; Casper, Kristin A.

doi:10.2146/ajhp140294

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…5,14 Other activities have included adherence assessment, patient education on self-monitoring and symptom management, diet, and smoking cessation. 5,[16][17][18][19][20][21] In 2013, based on existing evidence at the time, the Heart Failure Society of America and ACCP released a joint policy statement on the role of clinical pharmacy services in the management of patients with HF. 14 This policy statement described several key roles for pharmacists in the management of HF, including prevention of adverse drug reactions and medication errors, therapeutic drug monitoring, medication reconciliation, and medication adherence across the spectrum of HF management, both inpatient and outpatient.…”

Section: Delphi Resultsmentioning

confidence: 99%

“…Trials of pharmacist intervention that focused on medication education, pharmacotherapy recommendations to other clinicians, and telephone follow‐up have been described as early as 1999, with an associated reduction in non‐fatal HF events 5,14 . Other activities have included adherence assessment, patient education on self‐monitoring and symptom management, diet, and smoking cessation 5,16–21 . In 2013, based on existing evidence at the time, the Heart Failure Society of America and ACCP released a joint policy statement on the role of clinical pharmacy services in the management of patients with HF 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Although this likely reflects variation in roles and scope of clinical pharmacy practice, it remains unclear which activities represent optimal pharmaceutical care in the ambulatory HF clinic setting. As described by Singrey and colleagues, the provision of optimal patient care occurs when the respective expertise of each health care team member is utilized 21 . HF pharmacists are well positioned to contribute to optimal patient care in HF ambulatory clinics, thus their expertise and role within ambulatory HF care should be clearly defined.…”

Section: Introductionmentioning

confidence: 99%

“…As described by Singrey and colleagues, the provision of optimal patient care occurs when the respective expertise of each health care team member is utilized. 21 HF pharmacists are well positioned to contribute to optimal patient care in HF ambulatory clinics, thus their expertise and role within ambulatory HF care should be clearly defined.…”

mentioning

confidence: 99%

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Defining pharmacist activities in ambulatory heart failure clinics: North American survey and modified Delphi study

Beauchesne

Koshman

Beavers

et al. 2023

J Am Coll Clin Pharm

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BackgroundPharmacists are key members of multidisciplinary heart failure (HF) clinics; however, there is variation in their roles and activities. This study aimed to: (1) define current roles of HF clinic pharmacists and (2) develop a consensus‐based list of key activities for HF clinic pharmacists.MethodsIn part 1, we invited Canadian and American HF clinic pharmacists to complete a survey on activities currently performed in the HF clinic. Part 2 consisted of a three‐round modified Delphi study including only Canadian participants to define key activities for ambulatory HF pharmacists among 44 candidates. In each round, participants rated a list of candidate activities based on importance and priority on a 9‐point Likert scale. Consensus was reached for inclusion when ≥75% of participants rated both criteria ≥7, or exclusion when both criteria ≤6. Participants received personal responses alongside aggregate ratings after each round to facilitate attainment of consensus.ResultsEighty‐four pharmacists participated in part 1, and 29 (of 55 invited) participated in part 2 (24 retained for all three rounds). Current pharmacist activities were similar between American and Canadian participants, with an emphasis on patient assessment and clinical activities including modification of HF‐specific pharmacotherapy. The final consensus‐based list included 32 activities, with high priority placed on activities involving optimization of medications for HF and common comorbidities, engaging in shared decision‐making, assessing adherence, reviewing lab tests, and assessing and modifying medications due to pharmacokinetic/pharmacodynamic parameters, which closely mirrored activities in current practice.ConclusionCurrent activities of ambulatory HF pharmacists are largely consistent within North America, focusing on patient assessment and HF‐specific pharmacotherapy modification. Our consensus‐based list defined 32 activities integral to the future role of pharmacists in HF clinics, which builds upon activities being currently performed. This provides a framework to standardize and expand the scope of practice for clinical pharmacy services in HF clinics.

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