The following is the summary of “Impact of a Medication Optimization Clinic on Heart Failure Hospitalizations” published in the February 2023 issue of Cardiovascular Disease by Coons, et al.

Outcomes for patients with heart failure and a reduced ejection fraction (HFrEF) may be influenced by efforts to optimize guideline-directed medical therapy (GDMT) through team-based care. This research aimed to assess the effect of a novel medication optimization clinic (MOC) on GDMT and outcomes in individuals with HFrEF. If a patient with HFrEF is not getting the best GDMT, they will be referred to MOC, where they will be cared for by a multidisciplinary team, including a nurse practitioner or PA, a clinical pharmacist, and an HF cardiologist. 

To do this, researchers used a 2:1 propensity-matched control group to compare the results of MOC (n=206) with those of normal care (n=412). Hospitalizations for heart failure were the major clinical outcome measured 3 months after the index visit. In addition, adjusted Cox proportional hazards regression models and Kaplan-Meier cumulative event curves were performed. The proportion of patients in MOC treated with quadruple therapy (49% vs. 4%, P<0.0001), angiotensin receptor neprilysin inhibitor (60% vs. 27%, P<0.0001), mineralocorticoid receptor antagonist (59% vs. 37%, P<0.0001), and sodium-glucose cotransporter-2 inhibitor (60% vs. 10%, P<0.0001).   

The MOC group had a significantly lower primary result than the control group (log-rank, P=0.0008). Patients in the control group had a (P=0.0014) higher risk of hospitalization due to HF than those in the MOC group, as determined by Cox regression. Patients with HFrEF who had completed the MOC had better GDMT and were less likely to require hospitalization for HF.