Campbell Gayle, Doherty Ciara, D'Silva Andrew, Carr-White Gerald, Webb Jessica, Ismail Tevfik F
Cardiology Department, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK.
School of BMEIS, King's College London, London, UK.
Int J Clin Pharm. 2025 Feb;47(1):8-14. doi: 10.1007/s11096-024-01808-9. Epub 2024 Oct 5.
Medications form the basis of treatment for heart failure (HF) and adherence is crucial as untreated HF has a mortality of greater than 30%. As such, specialist HF pharmacists with expertise in prescribing and promoting adherence have become an integral part of the wider HF multidisciplinary team (MDT).
To implement specialist HF pharmacist prescribing clinics and evaluate their impact.
An integrated HF team at a tertiary London hospital.
The clinic was initially developed to facilitate the introduction of sacubitril-valsartan evolving to 6 dedicated clinics/week.
A dedicated electronic referral pathway was created to channel referrals to the specialist clinic, and referral criteria expanded to all patients requiring optimisation of medical therapy.
Data were retrospectively collected for patients with heart failure with reduced ejection fraction seen in the HF pharmacist clinic between September 2021 and July 2022. Overall, 114 patients were seen (mean age 66 years, 78 male). The mean time to medication optimisation was 3 months (averaging 1 appointment/month). The number on optimised doses of guideline-directed medical therapy, increased significantly from 8% at first appointment to 76% on discharge (p < 0.001). The HF pharmacists reviewed all medications and optimised non-HF medications for 17.5% (n = 20) of patients.
HF pharmacists can optimise patients' HF and non-HF medical therapy typically within 3 months. By reviewing all prescribed medications, HF pharmacists provide a holistic review of all medications. They can play a vital role in addressing the underutilisation of HF medical therapy and thereby improving patient outcomes.
药物治疗是心力衰竭（HF）治疗的基础，由于未经治疗的心力衰竭死亡率超过30%，因此坚持用药至关重要。因此，在处方和促进坚持用药方面具有专业知识的心力衰竭专科药剂师已成为更广泛的心力衰竭多学科团队（MDT）的重要组成部分。
实施心力衰竭专科药剂师处方诊所并评估其影响。
伦敦一家三级医院的综合心力衰竭团队。
该诊所最初是为了便于引入沙库巴曲缬沙坦而设立的，后来发展为每周6个专门诊所。
创建了一条专门的电子转诊途径，将转诊引导至专科诊所，并将转诊标准扩大到所有需要优化药物治疗的患者。
回顾性收集了2021年9月至2022年7月在心力衰竭药剂师诊所就诊的射血分数降低的心力衰竭患者的数据。总体而言，共诊治了114例患者（平均年龄66岁，男性78例）。药物优化的平均时间为3个月（平均每月1次就诊）。指南指导的药物治疗优化剂量的患者数量从首次就诊时的8%显著增加到出院时的76%（p < 0.001）。心力衰竭药剂师审查了所有药物，并为17.5%（n = 20）的患者优化了非心力衰竭药物。
心力衰竭药剂师通常可以在3个月内优化患者的心力衰竭和非心力衰竭药物治疗。通过审查所有处方药物，心力衰竭药剂师对所有药物进行全面审查。他们在解决心力衰竭药物治疗利用不足的问题从而改善患者预后方面可以发挥至关重要的作用。
