Abstract 10742: In-Hospital Virtual Peer-to-Peer Consultation to Improve Guideline-Directed Medical Therapy for Heart Failure: A Pilot Randomized Trial

• DOI: 10.1161/circ.146.suppl_1.10742
• Publication Date: 2023-06-15T12:36:45Z
• Authors: Vishal N Rao; Anand Shah; Jaime McDermott; Stephanie Barnes; Evan Murray; Michelle D Kelsey; Stephen J Greene; Marat Fudim; Adam D Devore; Michael A BLAZING; Cara OBrien; Robert J Mentz
• Keywords: Guideline; Medical Therapy

Introduction: Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) improves clinical outcomes and quality of life. Optimizing GDMT in the hospital is associated greater long-term use HFrEF. Hypothesis: A multidisciplinary virtual HF intervention optimization among patients HFrEF admitted any cause. Methods: In this pilot randomized, controlled study, consecutive to non-cardiology medicine services cause were identified at Duke Hospital between May September 2021. Major exclusions end-stage renal disease, hemodynamic instability, hospice care. Patients randomized a clinician-level peer-to-peer consult providing recommendations information on medication costs vs. usual Primary endpoints included 1) proportion new initiation or use, 2) changes optimal (OMT) scores which target dosing (range 0-9). Results: Of 242 identified, 91 (38%) eligible (N=52) care (N=39). Baseline characteristics similar (mean age 63 67 years, 23% 26% female, 46% 49% Black, mean EF 33% 31%). admission was also similar. There proportions continuation compared ( Figure 1 ). After adjusting OMT score admission, discharge higher group (+0.44 -0.31, absolute difference +0.75, adjusted estimate 0.86 ± 0.42; p=0.041). Conclusions: Among hospitalized services, consultation increased dose discharge.