Impact of Pharmacist-led Heart Failure Clinic Towards Clinical Outcomes of Heart Failure Patients With Reduced Ejection Fraction
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Abstract
Introduction: Heart failure causes high mortality and hospitalization. Pharmacist interventions help, but studies on pharmacist-led HF clinics in Malaysia are limited. Method: This study aimed to evaluate the influence of a pharmacist-led heart failure clinic on the clinical outcomes of heart failure patients with reduced ejection fraction. This was a quasi-experimental study conducted at Hospital Pulau Pinang in Malaysia. New patients attending the heart failure clinic were screened, and through convenient sampling, they were enrolled into intervention (HF-MTAC) and usual care (UC) groups. At the clinic, pharmacists provided patient education, counselling, and recommended dosage adjustments to physicians. Patients were observed and followed up for 9 months. Results: A total of 70 patients were recruited for each group. Pharmacist intervention led to significantly lower cardiovascular (CV) hospitalizations among the patients (40.0% in UC versus 18.6% in HF-MTAC group, p = 0.005). A significantly higher rate of CV-related emergency department (ED) visits was observed in the HF-MTAC group (11.4%) compared to the UC group (1.4%) (p = 0.033). However, no significant difference was observed in the CV-related mortality rate between the UC group (5.7%) and the HF-MTAC group (4.3%). The HF-MTAC group showed significant improvement in health-related quality of life according to the Minnesota Living with Heart Failure Questionnaire (MLHFQ), with median MLHFQ scores dropping from 7.00 to 2.00 (p < 0.001). Meanwhile, no significant change was observed in the UC group. Conclusion: These findings underscore the benefits of pharmacist-led heart failure clinics and suggest their implementation in Malaysian hospitals.
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