Heart Failure Transitions of Care: A Pharmacist-Led Post-Discharge Pilot Experience.

Abstract:

OBJECTIVE:To perform a pilot evaluation of a pharmacist-led, multidisciplinary transitional care clinic for heart failure (HF) patients. BACKGROUND:Transitions of care in HF should include: medication reconciliation, multidisciplinary care, early post-discharge follow-up, and prompt intervention on HF signs and symptoms. We hypothesized that combining these elements with optimization of medications would impact outcomes. METHODS:In the SERIOUS HF Medication Reconciliation Transitional Care Clinic (HF MRTCC), patients were seen by a clinical pharmacist trained in HF. The pharmacist performed medication reconciliation, a basic physical exam, and a HF symptom history. 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. Descriptive statistics and paired t-tests were used for medication doses. RESULTS:All patients (n=135) had a diagnosis of HF, 59% were recently discharged. The mean time from discharge to the clinic appointment was 10±6days, and the 30day all-cause readmission rate was 9%. Medication discrepancies were detected in 53% of patients. Medications were optimized in 70%, most frequently beta blockers, ace inhibitors, and diuretics. In patients with an ejection fraction ≤40%, significantly higher doses of beta blockers and ace inhibitors were prescribed after the clinic visit. CONCLUSION:The HF MRTCC identified and corrected numerous medication discrepancies, up-titrated medications, and was associated with a 30-day readmission rate of 9%. These encouraging pilot results are hypothesis-generating and warrant further controlled trials.

journal_name

Prog Cardiovasc Dis

authors

Milfred-LaForest SK,Gee JA,Pugacz AM,Piña IL,Hoover DM,Wenzell RC,Felton A,Guttenberg E,Ortiz J

doi

10.1016/j.pcad.2017.08.005

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

249-258

issue

2

eissn

0033-0620

issn

1873-1740

pii

S0033-0620(17)30113-5

journal_volume

60

pub_type

杂志文章
  • Reperfusion strategies in acute ST-elevation myocardial infarction: an overview of current status.

    abstract::Several randomized trials and meta-analyses have shown that primary angioplasty is superior to thrombolysis in the treatment of ST-segment elevation myocardial infarction (MI) in terms of death, reinfarction, and stroke. However, primary angioplasty should be regarded as the preferred strategy as long as it can not be...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2007.11.004

    authors: De Luca G,Suryapranata H,Marino P

    更新日期:2008-03-01 00:00:00

  • Cardiac endothelium and tissue growth.

    abstract::In recent years, a number of peptide and nonpeptide signalling autacoids have been implicated in the regulation of cardiac myocyte growth as well as vasculogenesis and angiogenesis, and in the function of cardiac muscle following development. In this review, we first examine the evidence for a role for specific cytoki...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/s0033-0620(97)80033-3

    authors: Balligand JL,Kelly RA,Smith TW

    更新日期:1997-01-01 00:00:00

  • Natural history of thoracic aortic aneurysms: size matters, plus moving beyond size.

    abstract::Thoracic aortic aneurysms (TAAs) are a prevalent and deadly disease that, without diagnosis and treatment, eventuates in life-threatening aortic dissection or rupture. While TAAs normally grow in an indolent manner, once a certain size (a "hinge point") is reached, the risk of dissection, rupture, and death increases ...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2013.05.007

    authors: Chau KH,Elefteriades JA

    更新日期:2013-07-01 00:00:00

  • Doxorubicin-induced cardiomyopathy from the cardiotoxic mechanisms to management.

    abstract::First isolated in the early 1960s, doxorubicin (DOX) remains among the most effective anticancer drug ever developed. However, this drug has proven to be a double-edged sword because it also causes a cardiomyopathy that leads to a form of congestive heart failure that is usually refractory to common medications. It is...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2006.10.002

    authors: Takemura G,Fujiwara H

    更新日期:2007-03-01 00:00:00

  • Exploring predisposition and treatment response--the promise of genomics.

    abstract::Spurred by large-scale public and private efforts as well as technological developments, the last few years have seen a major leap forward in our understanding of the genetic basis of cardiovascular disease. This revolution is in its infancy and will continue to alter the medical landscape for years to come. There is ...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2012.04.006

    authors: Pan S,Knowles JW

    更新日期:2012-07-01 00:00:00

  • Quantifying left ventricular function in heart failure: What makes a clinically valuable parameter?

    abstract::In heart failure (HF) management, noninvasive quantification of left ventricular (LV) function is rapidly evolving. Deformation parameters, such as strain, continue to challenge the central role of ejection fraction (EF) in diagnosis and prognostication of LV dysfunction in HF. The increasing recognition and use of de...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2020.05.007

    authors: Harbo MB,Nordén ES,Narula J,Sjaastad I,Espe EKS

    更新日期:2020-01-01 00:00:00

  • Epidemiology of Physical Activity and Exercise Training in the United States.

    abstract::The purpose of this review was to provide an overview of the descriptive epidemiology of physical activity (PA) and exercise training in the United States. Overall, there is a low prevalence of meeting the current PA guidelines in all age, sex and race/ethnic groups. Among adults the prevalence of meeting the aerobic ...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2017.01.004

    authors: Katzmarzyk PT,Lee IM,Martin CK,Blair SN

    更新日期:2017-01-01 00:00:00

  • Cardiac imaging in the geriatric population: what do we think we know, and what do we need to learn?

    abstract::Cardiac imaging plays an important role in coronary artery disease (CAD), congestive heart failure (HF) and valvular heart disease (VHD) in the elderly. Imaging defines the structure and function of the cardiac system, refining the understanding of patients' anatomy and physiology and informing a host of clinical care...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2014.07.003

    authors: Mehta N,Chokshi NP,Kirkpatrick JN

    更新日期:2014-09-01 00:00:00

  • Exercise Reveals Proline Dehydrogenase as a Potential Target in Heart Failure.

    abstract::The benefits of physical activity in cardiovascular diseases have long been appreciated. However, the molecular mechanisms that trigger and sustain the cardiac benefits of exercise are poorly understood, and it is anticipated that unveiling these mechanisms will identify novel therapeutic targets. In search of these m...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2019.03.002

    authors: Moreira JBN,Wohlwend M,Fenk S,Åmellem I,Flatberg A,Kraljevic J,Marinovic J,Ljubkovic M,Bjørkøy G,Wisløff U

    更新日期:2019-01-01 00:00:00

  • Functional anatomy and pathophysiologic principles in mitral regurgitation: Non-invasive assessment.

    abstract::Mitral regurgitation (MR) is the most prevalent cause of valvular heart disease (VHD) in western countries. In the Euro Heart Survey on VHD, MR was the second most common heart VHD requiring surgery. It is also the most common form of VHD in community and population-based studies from the United States. The categoriza...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2017.11.008

    authors: Maréchaux S,Illman JE,Huynh J,Michelena HI,Nkomo VT,Tribouilloy C

    更新日期:2017-01-01 00:00:00

  • Infective endocarditis of the mitral valve: optimal management.

    abstract::Infective endocarditis continues to be associated with significant morbidity and mortality despite recent advances in its management and remains a serious and challenging condition requiring a multidisciplinary approach. Surgery is essential in at least 50% of cases. Surgical outcomes have improved with the introducti...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2008.08.007

    authors: Zakkar M,Chan KM,Amirak E,Herrey A,Punjabi PP

    更新日期:2009-05-01 00:00:00

  • Aortic pain.

    abstract::With the exception of the pain of acute aortic dissection, the thoracic aorta is not usually considered as a pain-producing organ. However, nineteenth century clinicians considered the aorta as a source of cardiovascular pain in the presence of autopsy-documented inflammatory aortitis, aortic aneurysms, and arterial h...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/s0033-0620(98)80004-2

    authors: Wooley CF,Sparks EH,Boudoulas H

    更新日期:1998-05-01 00:00:00

  • Obesity and Kidney Disease.

    abstract::Obesity is a systemic disease of the white adipose tissue, which has evolved into a global epidemic. It is associated with a plethora of adipocyte hormonal (adipokine) imbalances, dysregulation of the energy-balance system, imbalances in metabolic homeostasis, a pro-inflammatory state and multiple target organ damages...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2018.07.005

    authors: Lakkis JI,Weir MR

    更新日期:2018-01-01 00:00:00

  • Electrophysiological basis of QT dispersion measurements.

    abstract::Dispersion of ventricular repolarization is a now widely used term describing nonhomogeneous recovery of excitability or heterogeneity of ventricular repolarization. It is usually expressed as the difference or the range of various repolarization measurements obtained from a heart. Experimentally, an increased dispers...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1053/pcad.2000.0420311

    authors: Franz MR,Zabel M

    更新日期:2000-03-01 00:00:00

  • Benefits of the Mediterranean Diet: Insights From the PREDIMED Study.

    abstract::The PREDIMED (PREvención con DIeta MEDiterránea) multicenter, randomized, primary prevention trial assessed the long-term effects of the Mediterranean diet (MeDiet) on clinical events of cardiovascular disease (CVD). We randomized 7447 men and women at high CVD risk into three diets: MeDiet supplemented with extra-vir...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2015.04.003

    authors: Martínez-González MA,Salas-Salvadó J,Estruch R,Corella D,Fitó M,Ros E,PREDIMED INVESTIGATORS.

    更新日期:2015-07-01 00:00:00

  • Secondary analysis of clinical trials--a cautionary note.

    abstract::There is concern in published reports and reviews that patients are being harmed or denied effective treatment by the use of questionable results from secondary analyses of data from clinical trials. A well-reported secondary analysis must make clear to the reader the uncertainty of the result--so clear, in fact, that...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2011.09.006

    authors: Marler JR

    更新日期:2012-01-01 00:00:00

  • Initial Assessment and Triage of the Stroke Patient.

    abstract::Nearly 800,000 strokes occur in the United States each year, and stroke is the leading cause of preventable permanent disability. Timely recognition and treatment are imperative to reduce stroke-related morbidity and mortality. Given the evidence supporting intravenous thrombolysis and mechanical thrombectomy for isch...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2017.04.004

    authors: Zweifler RM

    更新日期:2017-01-01 00:00:00

  • Advanced Imaging Techniques for Mitral Regurgitation.

    abstract::Mitral regurgitation (MR) is one of the most commonly encountered valvular lesions in clinical practice. MR can be either primary (degenerative) or secondary (functional) depending on the etiology of MR and the pathology of the mitral valve (MV). Echocardiography is the primary diagnostic tool for MR and is key in det...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2018.10.001

    authors: Quien MM,Vainrib AF,Freedberg RS,Bamira DG,Benenstein RJ,Williams MR,Saric M

    更新日期:2018-01-01 00:00:00

  • Transcatheter Valve Replacement for Right-sided Valve Disease in Congenital Heart Patients.

    abstract::Pulmonary and/or tricuspid valve dysfunction is common among individuals with congenital heart disease, and surgical intervention often carries prohibitive risks. Transcatheter valve replacement (TVR) of the right-sided cardiac valves has become a viable treatment option over the past two decades, while continued tech...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2018.09.003

    authors: Gales J,Krasuski RA,Fleming GA

    更新日期:2018-01-01 00:00:00

  • Impact of obesity and weight loss on cardiac performance and morphology in adults.

    abstract::Obesity, particularly severe obesity is capable of producing hemodynamic alterations that predispose to changes in cardiac morphology and ventricular function. These include increased cardiac output, left ventricular hypertrophy and diastolic and systolic dysfunction of both ventricles. Facilitated by co-morbidities s...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2013.09.003

    authors: Alpert MA,Omran J,Mehra A,Ardhanari S

    更新日期:2014-01-01 00:00:00

  • The preexcitation syndromes.

    abstract::Current methodology permits one to define the functional basis of the preexcitation syndromes with reasonable certainty and to develop a rationale for instituting trials of medical therapy. Future studies will hopefully result in a more exact definition of the anatomic substrates of preexcitation and their relationshi...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/0033-0620(78)90015-4

    authors: Gallagher JJ,Pritchett EL,Sealy WC,Kasell J,Wallace AG

    更新日期:1978-01-01 00:00:00

  • Management of trastuzumab-related cardiac dysfunction.

    abstract::Trastuzumab is the standard of care for the treatment of patients with ERB2-positive breast cancer. In a minority of patients, trastuzumab is associated with an increased incidence of cardiac dysfunction that ranges from asymptomatic decreases in left ventricular ejection fraction to symptomatic heart failure. In tria...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2010.07.001

    authors: Carver JR

    更新日期:2010-09-01 00:00:00

  • Osteoporosis as a model for the long-term clinical consequences of the menopause.

    abstract::The decrease in ovarian function culminating in the last menstrual period, the menopause, in women in their forties and fifties takes place over a period of 3 to 5 years. There are several immediate clinical consequences of the menopause that are easy to detect and treat, usually with hormone replacement. In contrast,...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/s0033-0620(95)80010-7

    authors: Kleerekoper M,Sullivan JM

    更新日期:1995-11-01 00:00:00

  • Pacemaker hemodynamics: clinical implications.

    abstract::Our review of the current literature and experience in caring for pacemaker patients suggests that a consideration of hemodynamics is a logical way to approach pacemaker selection and programming. Multiple clinical factors enter into the selection of a pacemaker or pacemaker programming settings in each case. It appea...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/0033-0620(92)90039-3

    authors: Buckingham TA,Janosik DL,Pearson AC

    更新日期:1992-03-01 00:00:00

  • Clinical and research measurement techniques of the pulmonary circulation: the present and the future.

    abstract::There has been a lot of progress in measurement techniques of the pulmonary circulation in recent years, and this has required updating of basic physiological knowledge. Pulmonary artery pressures (PAP) are normally low and dependent on left atrial pressure (LAP) and cardiac output (CO). Therefore, defining the functi...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2014.12.003

    authors: Naeije R,D'Alto M,Forfia PR

    更新日期:2015-03-01 00:00:00

  • Chronic thromboembolic pulmonary hypertension: a review of current practice.

    abstract::Pulmonary artery hypertension is a complex and multi-faceted disease process with numerous etiologies. Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed and highly treatable form of pulmonary hypertension. In this disease, certain patients with a history of pulmonary thromboembolic disease go ...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2012.07.005

    authors: Haythe J

    更新日期:2012-09-01 00:00:00

  • Chagas cardiomyopathy--where do we stand after a hundred years?

    abstract::A hundred years from its description, Chagas cardiomyopathy remains a challenging disease. Although successful vector-control strategies have decreased the incidence of Chagas disease in several Latin American countries, both migration to urban areas and immigration have spread the disease worldwide; and now, blood tr...

    journal_title:Progress in cardiovascular diseases

    pub_type: 历史文章,杂志文章,评审

    doi:10.1016/j.pcad.2009.11.008

    authors: Biolo A,Ribeiro AL,Clausell N

    更新日期:2010-01-01 00:00:00

  • Air pollution and cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis.

    abstract::Research to date demonstrates a relationship between exposure to ambient air pollutants and cardiovascular disease (CVD). Many studies have shown associations between short-term exposures to elevated levels of air pollutants and CVD events, and several cohort studies suggest effects of long-term exposure on cardiovasc...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,多中心研究,评审

    doi:10.1016/j.pcad.2011.02.001

    authors: Gill EA,Curl CL,Adar SD,Allen RW,Auchincloss AH,O'Neill MS,Park SK,Van Hee VC,Diez Roux AV,Kaufman JD

    更新日期:2011-03-01 00:00:00

  • Pathophysiological basis of syncope and neurological conditions that mimic syncope.

    abstract::The definition of syncope has clinical and pathophysiological parts. The clinical part is that syncope is a form of transient loss of consciousness (TLOC), while the pathophysiological element is that syncope differs from other forms of TLOC by virtue of the basis of true syncope - specifically cerebral hypoperfusion....

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2012.10.016

    authors: van Dijk JG,Wieling W

    更新日期:2013-01-01 00:00:00

  • Mechanisms of tissue injury in renal artery stenosis: ischemia and beyond.

    abstract::Renal injury distal to an atherosclerotic renovascular obstruction reflects multiple intrinsic factors producing parenchymal tissue injury. Atherosclerotic disease pathways superimposed on renal arterial obstruction may aggravate damage to the kidney and other target organs, and some of the factors activated by renal ...

    journal_title:Progress in cardiovascular diseases

    pub_type: 杂志文章,评审

    doi:10.1016/j.pcad.2009.09.002

    authors: Lerman LO,Textor SC,Grande JP

    更新日期:2009-11-01 00:00:00