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Veterans Affairs Pharmacist Heart Failure Medication Titration Project 1

Not Applicable
Conditions
Heart Failure
Registration Number
NCT06099808
Lead Sponsor
Stanford University
Brief Summary

This is a randomized quality improvement project to evaluate the impact of an audit and feedback intervention to motivate pharmacists to provide heart failure (HF) medication management to patients in the Veterans Health Administration (VHA) Sierra Pacific region (VISN 21). The results of this project could provide guidance for how to successfully scale a pharmacist-based HF remote management program in the VHA more broadly.

Pharmacists providing clinical care as part of Patient Aligned Care Team (PACT) within VHA VISN 21 will be included. Pharmacists will be randomized to one of 3 arms in a 1:1:2 ratio: (1) monthly audit and feedback of HF medication titration activities (AF) vs. (2) educational resources and monthly notification of HF medication titration actions in addition to a list of potential patients for HF optimization (AF+) vs. (3) usual care without audit and feedback (UC). Pharmacists across all three arms will be given access to shared educational resources on HF pharmacist care and educational webinars. Six months after the intervention, rates of pharmacist HF medication titration encounters will be compared among the 3 groups.

Detailed Description

Not available

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
110
Inclusion Criteria
  • Clinical pharmacists in the Veterans Health Administration that provide Patient Aligned Care Team (PACT) care in VA Sierra Pacific Network (VISN 21)
Exclusion Criteria
  • Excluded per pharmacist supervisor decision

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Number of monthly heart failure medication adjustment encounters2 months post-randomization to 6 months post-randomization

Encounters in which pharmacist adjusted heart failure medications

Secondary Outcome Measures
NameTimeMethod
Beta-blocker therapyAt 6 months post randomization

Percentage of patients with heart failure with reduced ejection fraction in each pharmacist panel that are treated with beta-blocker therapy

Number of new patients with pharmacist HF managementWithin 6 months post-randomization

For each pharmacist, will calculate the number of patients with heart failure in their panel that receive care from pharmacist that were not receiving care prior to randomization

Guideline medical therapy scoreAt 6 months post randomization

Composite score of heart failure medical therapy among patients with heart failure for patients within each pharmacists panel

Renin-angiotensin system inhibitor (RASI) therapyAt 6 months post randomization

Percentage of patients with heart failure with reduced ejection fraction in each pharmacist panel that are treated with RASI therapy

Percentage of heart failure patients with medication management by pharmacistWithin 6 months post-randomization

For each pharmacist, will calculate the percentage of patients with heart failure in their panel that receive medication adjustments from pharmacist

Angiotensin receptor neprilysin inhibitor (ARNI) therapyAt 6 months post randomization

Percentage of patients with heart failure with reduced ejection fraction in each pharmacist panel that are treated with ARNI therapy

Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) therapyAt 6 months post randomization

Percentage of patients with heart failure in each pharmacist panel that are treated with SGLT2i therapy

Mineralocorticoid receptor antagonist (MRA) therapyAt 6 months post randomization

Percentage of patients with heart failure in each pharmacist panel that are treated with MRA therapy

Trial Locations

Locations (1)

Palo Alto Veteran's Affairs Hospital

🇺🇸

Palo Alto, California, United States

Palo Alto Veteran's Affairs Hospital
🇺🇸Palo Alto, California, United States

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