Pharmacist Feedback Program Improves Heart Failure Care for Veterans

A new study presented at the American Heart Association's Scientific Sessions 2024 reveals that pharmacists in the Veterans Health Administration (VHA) system who received feedback on their heart failure patients' medication rates, along with educational resources, substantially increased their involvement in patient care and medication management for heart failure. This finding suggests a practical and scalable approach to improving heart failure treatment, a condition expected to affect over 8 million U.S. adults by 2035.

The PHARM-HF A&F Study, led by Dr. Alexander Tarlochan Singh Sandhu from Stanford University, involved 120 primary care pharmacists responsible for more than 7,000 heart failure patients. The pharmacists were divided into three groups: a control group receiving only educational materials, a group receiving educational materials plus monthly audit and feedback emails, and a third group receiving additional patient-specific information.

Results showed that pharmacists who received audit and feedback had 1.2 more patient visits per month focused on heart failure management and 0.2 more visits involving medication adjustments compared to the education-only group. This increase in engagement could lead to improved patient outcomes through more frequent and targeted care.

The study's findings are particularly significant given the unique role of primary care pharmacists in the VHA system. These pharmacists are embedded within primary care teams and have the authority to independently prescribe and adjust medications, making them well-positioned to impact heart failure care directly.

Dr. Sandhu noted, "This shows one approach to increasing the use of pharmacists to improve heart failure medication use, and it may also be applicable to other chronic diseases." The potential for broader application makes this intervention particularly promising for healthcare systems looking to optimize chronic disease management.

Interestingly, the addition of patient-specific information did not lead to further improvements beyond the audit and feedback approach. This unexpected result warrants further investigation to understand why this additional data did not enhance care and how the intervention could be refined.

The study's practical approach and scalability are among its strengths, suggesting that similar interventions could be implemented across large healthcare systems. However, limitations include the short duration of the study and the fact that patient-specific data was not restricted to each pharmacist's own roster.

As heart failure continues to pose a significant public health challenge, interventions that leverage existing healthcare resources, such as pharmacists, become increasingly valuable. This study demonstrates that relatively simple feedback mechanisms can lead to meaningful changes in care delivery, potentially improving outcomes for patients with chronic conditions.

The researchers plan to evaluate the longer-term impact of this intervention on medication rates and conduct qualitative interviews with pharmacists to refine the approach. They also aim to expand the program to more VHA locations in the coming year, which could provide further insights into its effectiveness across diverse patient populations.

This research highlights the importance of interdisciplinary approaches to chronic disease management and the potential for system-level interventions to improve patient care. As healthcare systems continue to seek efficient and effective ways to manage complex conditions like heart failure, the role of pharmacists and the impact of targeted feedback mechanisms may become increasingly central to patient care strategies.