Faraj Maggie N, Piña Ileana L, Garwood Candice
Department of Pharmacy, Detroit Medical Center, Detroit, MI.
Heart Hospital, Detroit Medical Center, Detroit, MI.
Innov Pharm. 2021 Sep 22;12(4). doi: 10.24926/iip.v12i4.4260. eCollection 2021.
Heart failure (HF) affects approximately 6 million in the United States and despite guideline-directed medical therapy (GDMT), still more than 20% of patients are readmitted within 30 days. This study evaluated the impact of a "pharmacist-led HF Brown Bag Clinic" (BBC) on HF patient outcomes including readmissions and mortality. This retrospective study, conducted at an academic medical center, included adult patients 18 to 89 years old with HF presenting to the BBC 7-14 days post HF hospitalization. Those failing to attend the BBC within 30 days of hospital discharge were in the control group. Our electronic medical records were used to capture patients' baseline characteristics and describe pharmacists' interventions. Thirty- and ninety-day post-discharge HF readmission and all-cause mortality were evaluated. A total of 32 patients met the inclusion criteria; 15 receiving intervention and 17 controls. A total of 18 HF hospital readmissions occurred, 4 (22%) readmissions in the intervention group and 14 (78%) in the control group (p= 0.06). Hospital readmissions within 30 days and 90 days were greater in the control group compared with the intervention group (18% vs. 7% and 41% vs. 21% respectively). A pharmacist-led post-discharge clinic demonstrated numerically fewer HF hospital readmissions compared with a scheduled but "no show" control group.
心力衰竭（HF）在美国影响着约600万人，尽管有指南指导的药物治疗（GDMT），但仍有超过20%的患者在30天内再次入院。本研究评估了“药剂师主导的心力衰竭棕色纸袋诊所”（BBC）对心力衰竭患者预后的影响，包括再入院率和死亡率。这项在一家学术医疗中心进行的回顾性研究纳入了18至89岁因心力衰竭在心力衰竭住院后7至14天到BBC就诊的成年患者。那些在出院后30天内未参加BBC的患者被纳入对照组。我们使用电子病历获取患者的基线特征并描述药剂师的干预措施。评估出院后30天和90天的心力衰竭再入院率和全因死亡率。共有32名患者符合纳入标准；15名接受干预，17名作为对照。总共发生了18次心力衰竭住院再入院，干预组有4次（22%）再入院，对照组有14次（78%）（p = 0.06）。对照组30天和90天内的医院再入院率高于干预组（分别为18%对7%和41%对21%）。与按计划就诊但“未出现”的对照组相比，药剂师主导的出院后诊所的心力衰竭住院再入院次数在数值上更少。
