Evaluation of a pharmacist-provider collaborative clinic for treatment of iron deficiency in patients with heart failure

• Published in: American journal of health-system pharmacy Vol. 80; no. 19; pp. 1326 - 1335
• Main Authors: Kido, Kazuhiko, Fang, Wei, Broscious, Rachael, Colvin, Bailey M, Kamal, Khalid M, Bianco, Christopher, Caccamo, Marco, Felpel, Kevin, Sokos, George
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 22-09-2023
• Subjects: Practice Research Reports; pharmacist; heart failure; iron; iron deficiency; pulmonary hypertension; anemia
• ISSN: 1079-2082; 1535-2900
• DOI: 10.1093/ajhp/zxad149

Abstract
Purpose
Intravenous iron therapy is recommended to improve symptoms and exercise tolerance in patients with heart failure (HF) with ­reduced ejection fraction and iron deficiency (ID), but there are limited published data on the implementation of intravenous iron therapy in practice. A pharmacist-provider collaborative ID treatment clinic was established within an advanced HF and pulmonary hypertension service to optimize IV iron therapy. The objective was to evaluate the clinical impacts of the pharmacist-provider collaborative ID treatment clinic.
Methods
A retrospective cohort study was performed to compare clinical outcomes among patients of the collaborative ID treatment clinic (the postimplementation group) and a cohort of patients who received usual care (the preimplementation group). The study included patients 18 years of age or older with diagnosed HF or pulmonary hypertension who met prespecified criteria for ID. The primary outcome was adherence to institutional intravenous iron therapy guidance. A key secondary outcome was ID treatment goal achievement.
Results
A total of 42 patients in the preimplementation group and 81 in the postimplementation group were included in the study. The rate of adherence to the institutional guidance was significantly improved in the postimplementation group (93%) compared to the preimplementation group (40%). There was no significant difference in the ID therapeutic target achievement rate between the pre- and postimplementation groups (38% vs 48%).
Conclusion
Implementing a pharmacist-provider collaborative ID treatment clinic significantly increased the number of patients who adhered to intravenous iron therapy guidance compared to usual care.