Abstract 13534: Reduced Hospitalizations, Emergency Room Vists and Death Among Patients Seen Once in a Heart Failure Bridge Clinic (HFBC) Program

• Published in: Circulation (New York, N.Y.) N.Y.), 2020-11, Vol.142 (Suppl_3 Suppl 3), p.A13534-A13534
• Main Authors: Upton, Addison, Sleater, Laura, Bankieis, Kaitlyn, Smith, LaVone, Trichon, Benjamin, Thohan, Vinay
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.13534

IntroductionMultidisciplinary clinics established in the care of heart failure patients are particularly impactful after hospital discharge. Clinical pharmacist integration with HFBC allows focused attention to optimizing guideline directed medical therapies (GDMT). The clinical impact of pharmacist inclusive HFBC requires further evaluation. HypothesisPatients with a HFBC encounter within 30 days after index heart failure hospitalization have reduced recurrent hospitalization, emergency room visits and mortality. MethodsAll patients with left ventricular ejection fraction (LVEF) less than 40% obtained within 90 days prior to hospital discharge from Mission Memorial Hospital between 8/2018 and 7/2019 were screened. Patients included in the HFBC arm had a clinic encounter within 30 days of hospital discharge and the remainder of patients comprised the control arm. Electronic and manual chart abstraction was used to assess and follow patients. Baseline characteristics were compared for differences using descriptive statistics. HFBC included clinical assessment, detailed heart failure education, medication reconciliation and adjustment with an emphasis on optimization of GDMT. Patients were followed for 90 day for the primary endpoints of hospitalization, emergency room visit and death ResultsA total of 1,463 patients (HFBC 307, Control 1156) comprised our final cohort. After accounting for baseline variables associated with endpoints the cumulative rates of hospitalization, emergency room visit or death still favor HFBC compared with controls at 90 days (HFBC 26% vs Control 32%, p=0.03). The 30 and 90 day frequencies of individual endpoints are represented in figure 1. ConclusionsClinical pharmacist integrated HFBC program allows for focused medication review and optimization is associated with 19% risk reduction in hospitalization, emergency room visit and death at 90 days.