Pharmacist Intervention to Optimize Guideline-Directed Medication Therapy (GDMT) in Patients with Heart Failure with Reduced Ejection Fraction (HFrEF)

Document Type

Abstract

Publication Date

3-6-2026

Abstract

Purpose: Pharmacist participation in managing chronic disease states through collaborative practice agreements (CPAs) has been a commonly increasing practice and has demonstrated positive impacts towards clinical goals and provider satisfaction. Heart failure with reduced ejection fraction (HFrEF) is a complex disease state with many pharmacological components. HFrEF has 4 pillars of guideline-directed medication therapy, medication monitoring requirements, and a cost barrier. Pharmacist involvement is crucial towards managing these patients. The objective of this study is to showcase the benefits of pharmacist involvement as it pertains to patient outcomes, provider satisfaction, and support the addition of a pharmacist heart failure CPA. Methods: The study will involve a retroactive chart review of multiple patients. The primary endpoints that will be assessed are patient’s GDMT optimization based on a scoring system at discharge vs 6 months post-discharge and readmission with heart failure related causes at 6 months. For secondary endpoints, the study will assess time to adequate GDMT, and physician time use in the 6-month post discharge period. Patients who have pharmacist involvement in their care as part of their discharge will be compared to patients without pharmacist involvement. Patients must meet the following inclusion criteria: at least 18 years of age, must follow with an in-network primary care provider or cardiologist, must have a diagnosis of HFrEF, and documented follow-up appointment. Exclusion criteria are defined as patients who are discharged to palliative or hospice care or discharged to skilled nursing facility or other long term care facility. All information collected via chart will be deidentified and logged in a secure and encrypted hospital protected database. The scoring system for GDMT will be dose based and involve the four pillars of GDMT. All other endpoints will be reviewed for comparison between groups. Appropriate statistical analysis will be conducted.

Publication Title

American Journal of Health-System Pharmacy

Volume

83

Issue

Supplement 2

First Page

S1209

Last Page

S1209

Comments

Advancing Science, Pharmcy Practice, and Health Outcomes Midyear Clinical Meeting, ASHP 2025 held December 7-10, 2025 in Las Vegas, NV.

Link to Full Text

Open Access

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