West Virginia University School of Pharmacy, Morgantown, WV, USA.
West Virginia Center for Translational Science Institute, Morgantown, WV, USA.
Am J Health Syst Pharm. 2023 Sep 22;80(19):1326-1335. doi: 10.1093/ajhp/zxad149.
Intravenous iron therapy is recommended to improve symptoms and exercise tolerance in patients with heart failure (HF) with -reduced ejection fraction and iron deficiency (ID), but there are limited published data on the implementation of intravenous iron therapy in practice. A pharmacist-provider collaborative ID treatment clinic was established within an advanced HF and pulmonary hypertension service to optimize IV iron therapy. The objective was to evaluate the clinical impacts of the pharmacist-provider collaborative ID treatment clinic.
A retrospective cohort study was performed to compare clinical outcomes among patients of the collaborative ID treatment clinic (the postimplementation group) and a cohort of patients who received usual care (the preimplementation group). The study included patients 18 years of age or older with diagnosed HF or pulmonary hypertension who met prespecified criteria for ID. The primary outcome was adherence to institutional intravenous iron therapy guidance. A key secondary outcome was ID treatment goal achievement.
A total of 42 patients in the preimplementation group and 81 in the postimplementation group were included in the study. The rate of adherence to the institutional guidance was significantly improved in the postimplementation group (93%) compared to the preimplementation group (40%). There was no significant difference in the ID therapeutic target achievement rate between the pre- and postimplementation groups (38% vs 48%).
Implementing a pharmacist-provider collaborative ID treatment clinic significantly increased the number of patients who adhered to intravenous iron therapy guidance compared to usual care.
静脉铁剂治疗被推荐用于改善射血分数降低和铁缺乏（ID）的心力衰竭（HF）患者的症状和运动耐量，但关于静脉铁剂治疗在实践中的应用，发表的数据有限。在先进的 HF 和肺动脉高压服务中建立了一个药师-提供者合作的 ID 治疗诊所，以优化 IV 铁剂治疗。目的是评估药师-提供者合作的 ID 治疗诊所的临床影响。
进行了一项回顾性队列研究，比较了合作 ID 治疗诊所（实施后组）和接受常规护理的患者队列（实施前组）的临床结局。研究纳入了年龄在 18 岁或以上、诊断为 HF 或肺动脉高压且符合 ID 预设标准的患者。主要结局是遵守机构静脉铁剂治疗指南。一个关键的次要结局是 ID 治疗目标的实现。
实施前组共 42 例患者，实施后组共 81 例患者纳入研究。实施后组的依从性显著提高（93%），而实施前组的依从性（40%）显著提高。两组 ID 治疗目标的实现率无显著差异（38% vs 48%）。
与常规护理相比，实施药师-提供者合作的 ID 治疗诊所显著增加了遵守静脉铁剂治疗指南的患者人数。
