Community pharmacist outreach program directed at physicians treating congestive heart failure

Area of Science:

• Pharmacology
• Cardiology
• Health Services Research

Background:

• Congestive heart failure (CHF) management often involves digoxin and furosemide.
• Angiotensin-converting-enzyme (ACE) inhibitors are crucial for CHF treatment but may be underutilized.
• Pharmacist-led interventions can potentially improve medication adherence and outcomes.

Purpose of the Study:

• To assess the predictive value of digoxin and furosemide for identifying CHF patients.
• To evaluate the utilization of ACE inhibitors in CHF patients.
• To determine the effectiveness of a pharmacist outreach program in increasing ACE inhibitor use.

Main Methods:

• A study on Newfoundland's Avalon Peninsula involved community pharmacists and physicians.
• Pharmacists identified patients on digoxin and furosemide, with or without ACE inhibitors or angiotensin II-receptor inhibitors.
• Physicians confirmed CHF diagnoses and ACE inhibitor use; intervention groups received academic detailing on ACE inhibitors.

Main Results:

• Digoxin and furosemide had a 94% positive predictive value for identifying CHF patients.
• 76% of CHF patients on digoxin and furosemide were prescribed an ACE inhibitor.
• Only 36% of CHF patients on ACE inhibitors received the target dosage; the outreach program showed no significant prescribing changes.

Conclusions:

• Digoxin and furosemide are reliable indicators for CHF identification.
• Pharmacist outreach did not significantly alter ACE inhibitor prescribing patterns or dosages.
• The pharmacist outreach program proved valuable for quality assurance in CHF management.