Guideline-led prescribing to ambulatory heart failure patients in a cardiology outpatient service
dc.check.date | 2022-01-07 | |
dc.check.info | Access to this article is restricted until 12 months after publication by request of the publisher. | en |
dc.contributor.author | El Hadidi, Seif | |
dc.contributor.author | Vaughan, Carl | |
dc.contributor.author | Kerins, David | |
dc.contributor.author | Byrne, Stephen | |
dc.contributor.author | Darweesh, Ebtissam | |
dc.contributor.author | Bermingham, Margaret | |
dc.contributor.funder | Future University in Egypt | en |
dc.contributor.funder | University College Cork | en |
dc.date.accessioned | 2021-10-08T15:15:55Z | |
dc.date.available | 2021-10-08T15:15:55Z | |
dc.date.issued | 2021-01-07 | |
dc.date.updated | 2021-10-08T14:18:49Z | |
dc.description.abstract | Background Guidelines recommend heart failure (HF) patients be treated with multiple medications at doses proven to improve clinical outcomes. Objective To study guideline-led prescribing in an Irish outpatient HF population. Setting Cardiology Outpatient Clinic, Mercy University Hospital, Cork, Ireland. Methods Guideline-led prescribing was assessed using the Guideline Adherence Index (GAI-3), that considered the prescribing of ACE inhibitors and angiotensin receptor blockers; beta-blockers and mineralocorticoid receptor antagonists. The GAI-based target dose was calculated based on the prescription of ≥ 50% of the guideline-recommended target dose of each of the three GAI medications to HF patients with ejection fraction ≤ 40%. High-GAI was achieved by prescription of ≥ 2 GAI medicines. Potentially inappropriate prescribing was assessed using a HF-specific tool. Main outcome measure Heart failure guideline-led prescribing assessed using the GAI-3. Results A total of 127 HF patients, mean age 71.7 ± 13.1 years, were identified in the study. Seventy-one patients had ejection fraction ≤ 40%. Population mean GAI-3 was 65.8%. When contraindications to therapy are considered, the adjusted GAI-3 increased to 72.9%. The target dose GAI was 18.5%. High-GAI management was prescribed to 54 patients (76.1%). A potentially inappropriate medicine in HF was prescribed to 14 (19.7%) patients. Conclusion Most HF patients with ejection fraction ≤ 40% in this setting received optimal guideline-led prescribing however the proportion of patients achieving the target doses of these agents was suboptimal. | en |
dc.description.status | Peer reviewed | en |
dc.description.version | Accepted Version | en |
dc.format.mimetype | application/pdf | en |
dc.identifier.citation | El Hadidi, S., Vaughan, C., Kerins, D., Byrne, S., Darweesh, E. and Bermingham, M. (2021) 'Guideline-led prescribing to ambulatory heart failure patients in a cardiology outpatient service', International Journal of Clinical Pharmacy, 43(4), pp. 1082-1089. doi: 10.1007/s11096-020-01220-z | en |
dc.identifier.doi | 10.1007/s11096-020-01220-z | en |
dc.identifier.endpage | 1089 | en |
dc.identifier.issn | 2210-7711 | |
dc.identifier.journaltitle | International Journal of Clinical Pharmacy | en |
dc.identifier.startpage | 1082 | en |
dc.identifier.uri | https://hdl.handle.net/10468/12077 | |
dc.identifier.volume | 43 | en |
dc.language.iso | en | en |
dc.publisher | Springer | en |
dc.relation.uri | https://link.springer.com/article/10.1007%2Fs11096-020-01220-z | |
dc.rights | © The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature 2021. This is a post-peer-review, pre-copyedit version of an article published in the International Journal of Clinical Pharmacy. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11096-020-01220-z | en |
dc.subject | Beta-blockers | en |
dc.subject | Guideline adherence index | en |
dc.subject | Guideline-directed medical therapies | en |
dc.subject | Guideline-led prescribing | en |
dc.subject | Heart failure | en |
dc.subject | Inappropriate prescribing | en |
dc.subject | Renin-angiotensin system | en |
dc.title | Guideline-led prescribing to ambulatory heart failure patients in a cardiology outpatient service | en |
dc.type | Article (peer-reviewed) | en |
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