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Peer-reviewedCC BY-NC-ND 4.0JACC Case Reports

Improving Guideline-Directed Medical Therapy in Hospitalized HFrEF Patients

  • Abdul Allam Khan1
  • Matthew Amaral2
  • Manav Ghaie1
  • Huzaifa Rashid1
  • Jenna Iannuccilli1
  1. 1Department of Internal Medicine, Landmark Medical Center, Woonsocket, Rhode Island, USA
  2. 2Department of Pharmacy, Landmark Medical Center, Woonsocket, Rhode Island, USA
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Abstract

Background: Guideline-directed medical therapy (GDMT) reduces mortality and rehospitalization in heart failure with reduced ejection fraction (HFrEF), yet many hospitalized patients are discharged without optimal therapy.

Project Rationale: A baseline audit at our community teaching hospital showed fewer than half of eligible patients were discharged on ≥3 GDMT pillars, driven by cost barriers, deferred titration, and inconsistent education.

Project Summary: A multidisciplinary Plan-Do-Study-Act intervention standardized GDMT workflows, incorporating pharmacist-led admission review, structured checklists, teach-back counseling, a meds-to-beds program, and early outpatient follow-up. Among 62 postintervention versus 152 baseline patients, discharge on ≥3 pillars increased from 47.4% to 69.4% (P = 0.006), heart failure–specific 30-day readmissions decreased from 23.7% to 9.7% (P = 0.022), and all-cause readmissions from 30.9% to 16.1% (P = 0.028).

Limitations: Modest postintervention sample size warrants cautious interpretation.

Take-Home Message: Structured, pharmacy-supported GDMT workflows improved prescribing performance and reduced 30-day readmissions in HFrEF.

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Cite

BibTeXRIS
BibTeX
@article{khan2026improving,
  title = {{Improving Guideline-Directed Medical Therapy in Hospitalized HFrEF Patients}},
  author = {Abdul Allam Khan and Matthew Amaral and Manav Ghaie and Huzaifa Rashid and Jenna Iannuccilli},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.109658},
  url = {https://doi.org/10.1016/j.jaccas.2026.109658},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Improving Guideline-Directed Medical Therapy in Hospitalized HFrEF Patients
AU  - Abdul Allam Khan
AU  - Matthew Amaral
AU  - Manav Ghaie
AU  - Huzaifa Rashid
AU  - Jenna Iannuccilli
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109658
UR  - https://doi.org/10.1016/j.jaccas.2026.109658
AB  - Background: Guideline-directed medical therapy (GDMT) reduces mortality and rehospitalization in heart failure with reduced ejection fraction (HFrEF), yet many hospitalized patients are discharged without optimal therapy.  Project Rationale: A baseline audit at our community teaching hospital showed fewer than half of eligible patients were discharged on ≥3 GDMT pillars, driven by cost barriers, deferred titration, and inconsistent education.  Project Summary: A multidisciplinary Plan-Do-Study-Act intervention standardized GDMT workflows, incorporating pharmacist-led admission review, structured checklists, teach-back counseling, a meds-to-beds program, and early outpatient follow-up. Among 62 postintervention versus 152 baseline patients, discharge on ≥3 pillars increased from 47.4% to 69.4% (P = 0.006), heart failure–specific 30-day readmissions decreased from 23.7% to 9.7% (P = 0.022), and all-cause readmissions from 30.9% to 16.1% (P = 0.028).  Limitations: Modest postintervention sample size warrants cautious interpretation.  Take-Home Message: Structured, pharmacy-supported GDMT workflows improved prescribing performance and reduced 30-day readmissions in HFrEF.
SN  - 2666-0849
ER  -