European Geriatric Medicine

, Volume 9, Issue 1, pp 103–111 | Cite as

Feasibility of optimizing pharmacotherapy in heart failure patients admitted to an acute geriatric ward: role of the clinical pharmacist

  • Karolien Walgraeve
  • Lorenz Van der Linden
  • Johan Flamaing
  • Katleen Fagard
  • Isabel Spriet
  • Jos Tournoy
Research Paper
First Online:
Received:
Accepted:
  • 24 Downloads

Abstract

Purpose

Heart failure is associated with high mortality and (re)hospitalization rates. Multidisciplinary teams involving pharmacists are effective in preventing disease-related adverse outcomes such as heart-failure-related hospitalizations. We aimed to investigate the impact of integrating clinical pharmacists into a multidisciplinary care team on drug therapies in geriatric heart failure patients. Additionally, we wished to standardize the clinical pharmacy intervention by developing a comprehensive algorithm.

Methods

A prospective feasibility study was conducted in which systematic pharmaceutical recommendations in a geriatric heart failure population were given. Inclusion criteria were admission to the acute geriatric ward, a minimum age of 75 years and a diagnosis of heart failure. The number of pharmaceutical recommendations, the acceptance rate by the treating physician and the patients’ clinical tolerability of the recommendations were registered. Six months after discharge, the general practitioner was contacted to determine drug therapy and heart-failure-related clinical outcomes. We developed a comprehensive algorithm to provide a structured, step-by-step approach for the pharmacotherapeutic evaluation of older heart failure patients.

Results

Thirty patients were included over a 5-month period; one patient dropped out. Sixty-one pharmaceutical recommendations were formulated for the treating physicians of which 43 were accepted. Five recommendations were not tolerated by the patients. The majority of the recommendations regarded diuretic therapy. The final algorithm was considered to contain the basic items needed to provide a comprehensive pharmacotherapeutic evaluation.

Conclusions

A clinical pharmacist can play an important role in the optimization of therapy for HF patients in a geriatric ward.

Trial registration

Clinicaltrials.gov NCT02149940.

Keywords

Clinical pharmacy Heart failure Geriatric inpatient Multidisciplinary team 
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© European Geriatric Medicine Society 2017

Authors and Affiliations

  • Karolien Walgraeve
    • 1
  • Lorenz Van der Linden
    • 1
    • 2
  • Johan Flamaing
    • 3
    • 4
  • Katleen Fagard
    • 3
  • Isabel Spriet
    • 1
    • 2
  • Jos Tournoy
    • 3
    • 4
  1. 1.Pharmacy DepartmentUniversity Hospitals LeuvenLouvainBelgium
  2. 2.Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and PharmacotherapyKU LeuvenLouvainBelgium
  3. 3.Department of Geriatric MedicineUniversity Hospitals LeuvenLouvainBelgium
  4. 4.Department of Chronic Diseases, Metabolism and AgeingKU LeuvenLouvainBelgium

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