Heart failure prescribing quality at discharge from a critical care unit in Egypt: The impact of multidisciplinary care

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dc.contributor.authorEl Hadidi, Seif
dc.contributor.authorSamir Bazan, Naglaa
dc.contributor.authorByrne, Stephen
dc.contributor.authorDarweesh, Ebtissam
dc.contributor.authorBermingham, Margaret
dc.contributor.funderUniversity College Corken
dc.contributor.funderFuture University in Egypten
dc.date.accessioned2021-10-08T15:33:13Z
dc.date.available2021-10-08T15:33:13Z
dc.date.issued2020-09-01
dc.date.updated2021-10-08T15:24:03Z
dc.description.abstractDischarge prescriptions for heart failure (HF) patients may not adhere to the clinical practice guidelines. This study aimed to assess the impact of the clinical pharmacist as a member of a multidisciplinary team on the quality of prescribing to HF patients at discharge from a Critical Care Unit (CCU) in Egypt. This was a retrospective cohort study of HF patients discharged from the CCU between January 2013 and December 2017. Guideline Adherence Index (GAI-3) was used to assess guideline-directed prescribing at discharge. Multidisciplinary care was introduced to the CCU on 1 January 2016. The study included 284 HF patients, mean (±SD) age 66.7 ± 11.5 years, 53.2% male. Heart failure with reduced ejection fraction affected 100 patients (35.2%). At discharge, loop diuretics were prescribed to 85.2% of patients; mineralocorticoid receptor antagonists to 54.9%; angiotensin-converting enzyme inhibitors/angiotensin receptor blockers to 51.4%; and β-blockers to 29.9%. Population Guideline Adherence Index (GAI-3) was 45.5%. High-GAI was prescribed to 136 patients (47.9%). Patients with High-GAI were younger; less affected by chronic kidney disease and had fewer comorbidities than those without High-GAI. Prescription of β-blocker increased (24.1% vs. 38.6%, p < 0.001) and digoxin utilization decreased (34.7% vs. 23.7%, p < 0.049) after the introduction of the multidisciplinary care. The inclusion of a clinical pharmacist in the multidisciplinary care team may have a role in optimizing the prescribing of HF guideline-directed therapies at discharge from this setting.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid159en
dc.identifier.citationEl Hadidi, S., Samir Bazan, N., Byrne, S., Darweesh, E. and Bermingham, M. (2020) 'Heart Failure Prescribing Quality at Discharge from a Critical Care Unit in Egypt: The Impact of Multidisciplinary Care', Pharmacy, 8(3), 159 (11 pp). doi: 10.3390/pharmacy8030159en
dc.identifier.doi10.3390/pharmacy8030159en
dc.identifier.endpage11en
dc.identifier.issn2226-4787
dc.identifier.issued3en
dc.identifier.journaltitlePharmacyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/12078
dc.identifier.volume8en
dc.language.isoenen
dc.publisherMDPIen
dc.relation.urihttps://www.mdpi.com/2226-4787/8/3/159
dc.rights© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0)en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en
dc.subjectPharmacisten
dc.subjectHeart failureen
dc.subjectMultidisciplinary careen
dc.subjectGuideline adherenceen
dc.subjectGuideline-directed medical therapyen
dc.subjectEgypten
dc.titleHeart failure prescribing quality at discharge from a critical care unit in Egypt: The impact of multidisciplinary careen
dc.typeArticle (peer-reviewed)en
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