Bibliographic Details
| Title: |
Guideline-led prescribing to ambulatory heart failure patients in a cardiology outpatient service. |
| Authors: |
El Hadidi, Seif, Vaughan, Carl, Kerins, David, Byrne, Stephen, Darweesh, Ebtissam, Bermingham, Margaret |
| Source: |
International Journal of Clinical Pharmacy; Aug2021, Vol. 43 Issue 4, p1082-1089, 8p |
| Subject Terms: |
HEART failure patients, OUTPATIENT medical care, ANGIOTENSIN receptors, MINERALOCORTICOID receptors, HEART failure, MEDICAL prescriptions |
| Abstract: |
Background Guidelines recommend heart failure (HF) patients be treated with multiple medications at doses proven to improve clinical outcomes. Objective To study guideline-led prescribing in an Irish outpatient HF population. Setting Cardiology Outpatient Clinic, Mercy University Hospital, Cork, Ireland. Methods Guideline-led prescribing was assessed using the Guideline Adherence Index (GAI-3), that considered the prescribing of ACE inhibitors and angiotensin receptor blockers; beta-blockers and mineralocorticoid receptor antagonists. The GAI-based target dose was calculated based on the prescription of ≥ 50% of the guideline-recommended target dose of each of the three GAI medications to HF patients with ejection fraction ≤ 40%. High-GAI was achieved by prescription of ≥ 2 GAI medicines. Potentially inappropriate prescribing was assessed using a HF-specific tool. Main outcome measure Heart failure guideline-led prescribing assessed using the GAI-3. Results A total of 127 HF patients, mean age 71.7 ± 13.1 years, were identified in the study. Seventy-one patients had ejection fraction ≤ 40%. Population mean GAI-3 was 65.8%. When contraindications to therapy are considered, the adjusted GAI-3 increased to 72.9%. The target dose GAI was 18.5%. High-GAI management was prescribed to 54 patients (76.1%). A potentially inappropriate medicine in HF was prescribed to 14 (19.7%) patients. Conclusion Most HF patients with ejection fraction ≤ 40% in this setting received optimal guideline-led prescribing however the proportion of patients achieving the target doses of these agents was suboptimal. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
