A study presented at the American Heart Association's Scientific Sessions 2024 shows that providing feedback to pharmacists significantly improves care for veterans with heart failure. The research conducted within the Veterans Health Administration System found that pharmacists who received feedback on their patients' heart failure medication rates, along with educational tools, increased their engagement with patients and made more frequent adjustments to heart failure medications.
The PHARM-HF A&F Study involved 120 primary care pharmacists responsible for over 7,000 heart failure patients. Participants were randomly assigned to three groups: a control group receiving only educational materials, a group receiving educational materials plus monthly audit and feedback emails, and a third group receiving additional targeted information about patients with potential for medication regimen improvement. Results showed that pharmacists who received audit and feedback had 1.2 more patient visits per month focused on heart failure management and 0.2 more visits involving medication adjustments compared to the education-only group.
Lead study author Dr. Alexander Tarlochan Singh Sandhu, a cardiologist at Stanford University, emphasized the significance of these findings. "This shows one approach to increasing the use of pharmacists to improve heart failure medication use, and it may also be applicable to other chronic diseases," Sandhu stated. "This is a major opportunity to improve health for more patients, especially in a system like the Veterans Affairs Healthcare System with a large, robust network of pharmacists nationwide."
The importance of this research is underscored by the growing prevalence of heart failure in the United States. The American Heart Association projects that more than 8 million adults will have the condition by 2035, making effective management strategies crucial. One notable outcome of the study was a small but significant increase in the prescription of mineralocorticoid receptor antagonist medication, which has historically been underutilized in heart failure therapy. This suggests that the feedback program may help address gaps in guideline-recommended treatments.
The study's practical approach and scalability are among its strengths, indicating potential for widespread implementation. However, researchers noted that providing patient-specific data did not lead to additional improvements beyond the audit and feedback intervention, a finding that warrants further investigation. As heart failure continues to pose a significant public health challenge, interventions like this feedback program for pharmacists could play a crucial role in improving patient care. The researchers plan to evaluate the longer-term impact of the intervention and adapt it for implementation in more VHA locations in the coming year.
This study highlights the potential of leveraging pharmacists' expertise to enhance chronic disease management, particularly within integrated healthcare systems. By empowering pharmacists with targeted feedback and educational resources, healthcare providers may be able to significantly improve the quality of care for patients with heart failure and potentially other chronic conditions. The findings suggest that relatively simple interventions can yield meaningful improvements in clinical practice, especially within systems like the Veterans Health Administration that have established pharmacist networks.
