PMID- 34796093
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220428
IS  - 2230-5254 (Electronic)
IS  - 2230-5254 (Linking)
VI  - 10
DP  - 2021
TI  - Clinical Pharmacist's Intervention to Improve Medication Titration for Heart 
      Failure: First Experience from Sudan.
PG  - 135-143
LID - 10.2147/IPRP.S341621 [doi]
AB  - BACKGROUND: Medications known to improve outcomes in heart failure (HF) are 
      either not prescribed or prescribed at sub-therapeutic doses. The addition of 
      clinical pharmacists to the HF team positively impacts optimizing prognostic 
      medications for a patient with HF with reduced ejection fraction (HFrEF). 
      OBJECTIVE: To assess the intervention of the clinical pharmacist as part of the 
      multidisciplinary (MD) team in up-titration to achieve target doses of key 
      therapeutic agents for HFrEF. METHODS: This was a prospective one group 
      pretest-posttest interventional study; a comparison of the target dose 
      achievement of key therapeutic agents for HFrEF was performed before and after 
      clinical pharmacist interventions. RESULTS: Out of 110 HFrEF patients, 57.3% were 
      males, and the mean age of patients was 55.8 years (SD 12.6). Cardiomyopathy was 
      the leading cause of HF. At baseline, 86% were on angiotensin-converting enzyme 
      inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin 
      inhibitors (ACEIs/ARBs/ARNi) and 93.6% on beta blockers (BBs). At the end of 
      study, the proportion of patients achieved the target dose was significantly 
      increased (0 vs 77.4%, 6.8 vs 85.4%, and 0 vs 55.6%) for ACEIs, ARBs and ARNi, 
      respectively, and (8.6% vs 66.1%; P = 0.001) for BBs. Moreover, the up-titration 
      process was associated with significant improvement in most clinical as ejection 
      fraction and New York Heart Association (NYHA) scale and laboratory 
      characteristics. CONCLUSION: As a part of the MD team in the outpatient HF 
      clinic, the clinical pharmacists increased the percentage of HFrEF patients 
      achieving the target or maximal doses of key therapeutic agents and improving 
      clinical and laboratory parameters.
CI  - (c) 2021 Ahmed et al.
FAU - Ahmed, Kannan O
AU  - Ahmed KO
AD  - Department of Clinical Pharmacy, Faculty of Pharmacy, University of Gezira, Wad 
      Medani, Sudan.
FAU - Taj Eldin, Imad
AU  - Taj Eldin I
AD  - Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad 
      Medani, Sudan.
FAU - Yousif, Mirghani
AU  - Yousif M
AD  - Department of Clinical Pharmacy, Faculty of Pharmacy, University of Gezira, Wad 
      Medani, Sudan.
FAU - Albarraq, Ahmed A
AU  - Albarraq AA
AD  - Pharmacy Practice Research Unit, Department of Clinical Pharmacy, College of 
      Pharmacy, Jazan University, Jazan, Saudi Arabia.
FAU - Yousef, Bashir A
AU  - Yousef BA
AUID- ORCID: 0000-0001-7832-4556
AD  - Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, 
      Khartoum, Sudan.
FAU - Ahmed, Nasrein
AU  - Ahmed N
AD  - Department of Cardiology, Ahmed Gasim Cardiac Surgery and Renal Transplantation 
      Centre, Khartoum, Sudan.
FAU - Babiker, Anas
AU  - Babiker A
AD  - Department of Cardiology, Royal Care International Hospital, Khartoum, Sudan.
LA  - eng
PT  - Journal Article
DEP - 20211111
PL  - New Zealand
TA  - Integr Pharm Res Pract
JT  - Integrated pharmacy research & practice
JID - 101656778
PMC - PMC8593340
OTO - NOTNLM
OT  - Sudan
OT  - clinical pharmacist
OT  - heart failure
OT  - intervention
OT  - medications titration
COIS- The authors declare that they have no conflicts of interest for this work.
EDAT- 2021/11/20 06:00
MHDA- 2021/11/20 06:01
PMCR- 2021/11/11
CRDT- 2021/11/19 06:58
PHST- 2021/09/27 00:00 [received]
PHST- 2021/11/05 00:00 [accepted]
PHST- 2021/11/19 06:58 [entrez]
PHST- 2021/11/20 06:00 [pubmed]
PHST- 2021/11/20 06:01 [medline]
PHST- 2021/11/11 00:00 [pmc-release]
AID - 341621 [pii]
AID - 10.2147/IPRP.S341621 [doi]
PST - epublish
SO  - Integr Pharm Res Pract. 2021 Nov 11;10:135-143. doi: 10.2147/IPRP.S341621. 
      eCollection 2021.