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Pharmacist-led rapid uptitration clinic in heart failure patients with reduced ejection fraction: our experience within a virtual ward
File(s)
journal.pdig.0000868.pdf (844.78 KB)
Published version
Author(s)
Alhakem, Hussein
Murphy, Angela
Fusco, Liuba
McQueen, Grant
Pearse, Sarah
Type
Journal Article
Abstract
Heart failure with reduced ejection fraction (HFrEF) occurs when the heart is unable to pump blood efficiently throughout the body, leading to symptoms like fatigue, shortness of breath, and fluid retention. Clinical guidelines worldwide recommend starting medical therapy as early as possible, adjusted to the highest tolerated doses, to avoid worsening of symptoms and emergency hospitalisation. However, this process requires frequent clinician reviews and close monitoring, making it time-consuming for both patients and healthcare providers thus leading to suboptimal doses and early discontinuation of therapy. The STRONG-HF study demonstrated that accelerated dose adjustments, paired with regular follow-up, not only improved heart failure symptoms and quality of life of patients but also significantly reduced hospital admission and death, highlighting the knowledge gap in treatment optimisation strategies. Virtual wards offer an innovative solution allowing patients to be monitored remotely at home while still receiving the necessary dose adjustments and clinical care. In this paper, we share our experience in implementing this pathway, which has allowed us to start treatment early and seamlessly adjust medication doses in accordance with patient-specific parameters leading to an improvement in heart function, New York Heart Association (NYHA) score, and a reduction in heart failure related hospitalisation.
Date Issued
2025-06-01
Date Acceptance
2025-04-28
Citation
PLOS Digital Health, 2025, 4 (6)
URI
DOI
ISSN
2767-3170
Publisher
Public Library of Science (PLoS)
Journal / Book Title
PLOS Digital Health
Volume
4
Issue
6
Copyright Statement
Copyright: © 2025 Alhakem et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Publication Status
Published
Article Number
e0000868
Date Publish Online
2025-06-05