Case Studies

Brigham and Women’s Hospital instituted a cardiology-trained team of physicians and pharmacists to offer guideline-directed medical therapy (GDMT) to treatment teams and optimize treatment for patients with HFrEF hospitalized for a non-CV related event.

• Low awareness of emerging therapies contributed to clinical inertia
• A perception that patients are “stable” further contributed to patient and provider hesitancy to introduce new therapies or increase doses
• As a result, there were typically no changes to GDMT for patients with HF during a non-CV hospitalization

• The GDMT pilot study protocol was based on ACC/AHA/HFSA guidelines, randomized clinical trial evidence, drug- specific FDA package inserts, and expert consensus documents
• A virtual team of physicians and pharmacists offered GDMT suggestions during hospitalization of patients with HFrEF admitted for non-CV indications
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    Provided daily GDMT suggestions via page and EHR note

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    A control group received usual care

• At discharge, an email summarizing changes to the patient’s GDMT regimen, additional follow-up guidance, and out-of-pocket cost information was sent to each patient’s outpatient cardiologist
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    Patients without a treating cardiologist were provided a referral for an outpatient cardiologist