A strategy to improve adherence to guideline-directed medical therapy (GDMT) and the role of the multidisciplinary team in a heart-failure programme.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiovascular Journal of Africa Pub Date : 2024-01-23 Epub Date: 2023-05-05 DOI:10.5830/CVJA-2022-067
Waleed AlHabeeb, Fakhr Alayoubi, Ahmed Hayajneh, Anhar Ullah, Fayez Elshaer
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引用次数: 0

Abstract

Background: Heart failure (HF) patients place a heavy burden on the healthcare system because of their frequent need for in-patient treatment, emergency room visits and subsequent hospital stays. To provide proper care and effective therapy, practitioners have streamlined delivery techniques such as clinical pathways, checklists and pocket manuals. However, a description of the establishment of a disease-management programme, including a multidisciplinary team of physicians, clinical pharmacists and nurse specialists is required. The aim of this study was to highlight the role of the multidisciplinary team in a heart-failure programme by assessing the improvement in adherence to guideline-directed medical therapy.

Methods: A retrospective, observational research was undertaken on patients with HF at a cardiac centre in Riyadh, to observe the HF patients' management before (January to December 2014) and after (January to December 2015) the establishment of a programme.

Results: The use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers was 75.59% in 2014 at discharge and 81.17% in 2015 (p = 0.249). Beta-blockers use at release increased from 87.83% in 2014 to 94.53% in 2015 (p = 0.021). The flu vaccine was given to 48.24% of patients in 2014 and 75.13% of the patients in 2015 (p < 0.001). The pneumococcal vaccine was administered to 44.22% of patients in 2014 and 75.13% of patients in 2015 (p < 0.001). The ejection fraction improved from 30.21% in the first month to 39.56% in the 12th month (p = 0.001) in patients managed in 2015.

Conclusion: The multidisciplinary heart-failure programme resulted in a positive effect, in the form of improved patient care after including the clinical pharmacist and nurse specialist.

提高指导性医疗疗法(GDMT)依从性的策略以及多学科团队在心脏衰竭项目中的作用。
背景:心力衰竭(HF)患者经常需要住院治疗、去急诊室就诊以及随后的住院治疗,这给医疗系统带来了沉重的负担。为了提供适当的护理和有效的治疗,医生们简化了临床路径、核对表和袖珍手册等提供技术。然而,还需要对疾病管理计划的建立进行描述,包括由医生、临床药剂师和专科护士组成的多学科团队。本研究的目的是通过评估对指南指导下的药物治疗的依从性的改善情况,突出多学科团队在心脏衰竭计划中的作用:方法:对利雅得一家心脏中心的高血压患者进行了一项回顾性观察研究,观察高血压患者在该计划设立之前(2014 年 1 月至 12 月)和之后(2015 年 1 月至 12 月)的治疗情况:2014年出院时血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂的使用率为75.59%,2015年为81.17%(P = 0.249)。出院时使用β受体阻滞剂的比例从2014年的87.83%增至2015年的94.53%(p = 0.021)。2014 年有 48.24% 的患者接种了流感疫苗,2015 年有 75.13% 的患者接种了流感疫苗(p < 0.001)。2014年有44.22%的患者接种了肺炎球菌疫苗,2015年有75.13%的患者接种了肺炎球菌疫苗(p < 0.001)。2015年接受治疗的患者射血分数从第一个月的30.21%提高到第12个月的39.56%(p = 0.001):多学科心衰计划产生了积极的效果,在纳入临床药剂师和专科护士后,患者护理得到了改善。
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来源期刊
Cardiovascular Journal of Africa
Cardiovascular Journal of Africa CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.30
自引率
0.00%
发文量
0
审稿时长
4-8 weeks
期刊介绍: The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
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