Pharmacist-Led Management Model for CHF
Trial question
What is the role of pharmacist-led management model for improving medication adherence in patients with chronic HF?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
41.0% female
59.0% male
N = 445
445 patients (182 female, 263 male).
Inclusion criteria: adult patients with chronic HF.
Key exclusion criteria: planned cardiac surgery during the study period; life expectancy < 1 year; history of malignant neoplasms; severe hepatic or renal dysfunction; pregnancy or lactation.
Interventions
N=223 pharmacist-led management (pharmacists conducted follow-up visits in accordance with standardized procedures with social media-based reminders and education).
N=222 usual care (nurses conducted follow-up visits in accordance with the standardized procedures).
Primary outcome
Percentage of patients achieving good medication adherence, as measured by mean proportion of days covered by heart failure medication at 52 weeks
95.2%
90.5%
95.2 %
71.4 %
47.6 %
23.8 %
0.0 %
Pharmacist-led
management
Usual
care
Significant
increase ▲
NNT = 21
Significant increase in the percentage of patients achieving good medication adherence, as measured by mean proportion of days covered by HF medication at 52 weeks (95.2% vs. 90.5%; IE 8.1, 95% CI 5.5 to 10.7).
Secondary outcomes
Significant increase in mean proportion of days covered ≥ 80% at 52 weeks (85.2% vs. 66.2%; OR 2.94, 95% CI 1.85 to 4.76).
Significant increase in mean proportion of days covered for diuretics at 52 weeks (94.6% vs. 83%; AD 11.6%, 95% CI 7.1 to 16.1).
Significant increase in mean proportion of days covered for β-blockers at 52 weeks (95.2% vs. 90.5%; AD 4.63%, 95% CI 0.23 to 9.04).
Safety outcomes
No significant difference in adverse events.
Conclusion
In adult patients with chronic HF, pharmacist-led management was superior to usual care with respect to the percentage of patients achieving good medication adherence, as measured by mean proportion of days covered by HF medication at 52 weeks.
Reference
Lingjiao Wang, Yuanyuan Zhao, Liping Han et al. Pharmacist-Led Management Model and Medication Adherence Among Patients With Chronic Heart Failure: A Randomized Clinical Trial. JAMA Netw Open. 2024 Dec 2;7(12):e2453976.
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