Background
During the COVID-19 pandemic, using innovative ways to add guideline-directed medical therapy (GDMT) in patients with heart failure with reduced ejection fraction (HFrEF) is critical. This study examines the feasibility of our Tele-Pharmacy HF clinic (TPHFC) to aid with GDMT use in such patients.
Methods
HFrEF patients seen in the TPHFC with ≥30-days follow-up (8/2019-11/2020) were retrospectively evaluated for demographics, GDMT use, and clinical events at our institution. The primary outcome was GDMT use. Secondary outcomes were triple or quadruple GDMT use, and death or unplanned events (ED, hospital, or HFC visit) from hypotension, acute kidney injury or potassium abnormality due to GDMT use.
Results
95 HFrEF patients (mean age 61±13 years, ejection fraction 30±13%) were seen in the TPHFC. Most had stage C HFrEF (85%) from non-ischemic cardiomyopathy (74%). 91% of TPHFC visits were virtual. TPHFC visits increased sodium glucose co-transporter2 (SGLT2) inhibitor (3 vs 37%, p<0.05), angiotensin-receptor neprilysin inhibitor (46 vs 66%, p=0.003), mineralocorticoid-receptor antagonist (57 vs 71%, p=0.03), and triple or quadruple GDMT (54 vs 72%, p=0.006) use over a median of 6 [4, 9] months follow-up (Figure 1). One patient died from end-stage HFrEF. 5% had GDMT-related unplanned events.
Conclusion
TPHFC referral was feasible and increased GDMT use including SGLT2 inhibitor during the pandemic. Future work should explore its impact on long-term adherence and clinical recovery.
Footnotes
Moderated Poster Contributions Saturday, May 15, 2021, 1:15 p.m.-1:25 p.m.
Session Title: Top Innovations of the Past Year: ECG Machine Learning and Telemedicine During COVID-19
Abstract Category: 60. Spotlight on Special Topics: Innovation, Digital Health, and Technology
Presentation Number: 1091-09