Abstract 16521: Using Electronic Health Record Data to Identify and Prioritize Patients With Heart Failure With Reduced Ejection Fraction for a Remote Medication Optimization Program

• DOI: 10.1161/circ.148.suppl_1.16521
• Publication Date: 2023-12-19T08:08:02Z
• Authors: Ozan Unlu; Alexander J Blood; John W Ostrominski; Hunter J Nichols; Samantha Subramaniam; Daniel Gabovitch; Jacqueline Chasse; Christopher P Cannon; Akshay S Desai; Benjamin Scirica; Kavishwar Wagholikar
• Keywords: Discontinuation; Medical record

Introduction: Remote medication management programs (RMMP) might be effective in optimizing guideline directed medical therapy (GDMT) for HFrEF. Identification of patients that can safely managed remotely and prioritization those with the highest need optimization is crucial, especially setting constrained resources. Methods: We analyzed records from our institutional enterprise data warehouse to identify HFrEF whom GDMT optimized by an RMMP within Mass General Brigham health system between May 2021 2023. After identifying a population HFrEF, we excluded contraindications higher risk adverse reactions. Next, identified active past medications using discontinuation (Figure). performed chart review on random sample 100 validate analysis. Results: have 1771 who are actively receiving care eligible remote optimization. Only 7% (129/1771) were prescribed all four GDMT, however 4% (78/1771) at least one these prescriptions was discontinued. Of patients, 45% (801/1771) had stopped including 50% SGLT2i, 30% MRA, 46% ARNI. Patients never as top priority RMMP. Conclusion: EHR effectively prioritize Similar prior registries, study showed poor utilization GDMT. However, it also revealed significant number their Investigating reasons discontinuations may elucidate barriers This expanded HFpEF HFmEF, refined further natural language processing, machine learning, incorporating refill, claims, dosages.