<--GAT-->

Cleveland VA Pharmacy Clinic Shows Promise in Heart Failure Pilot

by U.S. Medicine

October 16, 2017

CLEVELAND – A pilot evaluation of a pharmacist-led, multidisciplinary transitional care clinic for heart failure (HF) patients showed good results at the Louis Stokes Cleveland VAMC in Cleveland.

The report, published in Progress in Cardiovascular Diseases, noted that transitions of care in HF should include:

  • medication reconciliation,
  • multidisciplinary care,
  • early post-discharge follow-up, and
  • prompt intervention on HF signs and symptoms.

The VA pharmacy authors hypothesized that combining the elements with optimization of medications would positively affect outcomes.1

The SERIOUS HF Medication Reconciliation Transitional Care Clinic (HF MRTCC) was used to test that. Patients were seen by a heart-failure trained clinical pharmacist, who performed medication reconciliation, a basic physical exam, and a HF symptom history. All of the 135 patients had a diagnosis of HF, with 59% having been recently discharged from the hospital.

During the pilot, medications were adjusted by the clinical pharmacist or medical provider. Data were retrospectively collected for a quality improvement evaluation of this novel clinic on medication discrepancies, medications optimized, and 30-day readmissions…

Results indicated that the mean time from discharge to the clinic appointment was 10+6 days, and the 30-day all-cause readmission rate was 9%. Study authors reported that medication discrepancies were detected in 53% of patients.

Medications were optimized in 70% of patients, usually involving beta blockers, ace inhibitors, and diuretics. In patients with an ejection fraction of 40% or below, significantly higher doses of beta blockers and ace inhibitors generally were prescribed after the clinic visit, they said.

“The HF MRTCC identified and corrected numerous medication discrepancies, up-titrated medications, and was associated with a 30-day readmission rate of 9%.,” the researchers concluded. “These encouraging pilot results are hypothesis-generating and warrant further controlled trials.”

1: Milfred-LaForest SK, Gee JA, Pugacz AM, Piña IL, Hoover DM, Wenzell RC, Felton
A, Guttenberg E, Ortiz J. Heart failure transitions of care: A pharmacist-led
post- discharge pilot experience. Prog Cardiovasc Dis. 2017 Aug 18. pii:
S0033-0620(17)30113-5. doi: 10.1016/j.pcad.2017.08.005. [Epub ahead of print]
Review. PubMed PMID: 28826670.


Comments are closed here.


Related Articles

House Passes Bill to Create Education/Employment Arm of VA

WASHINGTON,—Legislators have reintroduced plans to create a fourth administration within the Department of Veterans Affairs—one dedicated to overseeing veterans’ education, transition and employment benefits. Currently these operations fall under the Veterans Benefits Administration, with VBA... View Article

Administrative Confusions Results in Little Oversight of VA’s Police Force

Suicides, Violence at VMACs Put Spotlight on Security WASHINGTON—As the number of suicides and other violent incidents at VA facilities grows, a spotlight is being thrown on VA’s internal police force and its ability to... View Article


U.S. Medicine Recommends


More From department of veterans affairs

Department of Veterans Affairs (VA)

House Passes Bill to Create Education/Employment Arm of VA

WASHINGTON,—Legislators have reintroduced plans to create a fourth administration within the Department of Veterans Affairs—one dedicated to overseeing veterans’ education, transition and employment benefits. Currently these operations fall under the Veterans Benefits Administration, with VBA... View Article

Department of Veterans Affairs (VA)

Administrative Confusions Results in Little Oversight of VA’s Police Force

Suicides, Violence at VMACs Put Spotlight on Security WASHINGTON—As the number of suicides and other violent incidents at VA facilities grows, a spotlight is being thrown on VA’s internal police force and its ability to... View Article

Department of Veterans Affairs (VA)

Veterans Using Dual Health Systems Have More Problems With Medications

CHARLESTON, SC—More than half of the patients treated by VA are also Medicare eligible, and that is increasing the risk for a range of prescription medication problems—from chronic disease medication nonadherence to opioid overdoses—among dual... View Article

Department of Veterans Affairs (VA)

All VA Healthcare Facilities to Be Completely Smoke-Free by October

New Directive Abolishes Designated Smoking Zones WASHINGTON—Starting in October, all VA healthcare facilities will be official no-smoking zones. While VA now permits smoking in designated areas, the department has issued a new policy restricting smoking... View Article

Department of Veterans Affairs (VA)

VA Isn’t Addressing Recommendations by Oversight Agencies

Too Many Leadership Vacancies Are Part of the Problem WASHINGTON—Deeply ingrained management problems are preventing VA from addressing priority recommendations from oversight agencies, leaving the department with long-standing weaknesses in its healthcare and disability benefits... View Article

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up