Pharmacists Praised for Heart Failure Care on Multidisciplinary Teams

The entire July 2015 issue of Heart Failure Clinics is devoted to team-based care. This is good news for pharmacists, who are hailed as key members of multidisciplinary care teams throughout the issue.

For multidisciplinary care in heart failure (HF), pharmacists join HF cardiologists and nurses, exercise specialists, dieticians, psychologists, and social workers on teams. Increasingly, these teams are working in inpatient or outpatient settings, at patients’ homes, or remotely.

The multidisciplinary team has a wide range of goals and responsibilities for HF patients, such as improving clinical outcomes, managing patient symptoms, and reducing health care costs.

One article published in Heart Failure Clinics extolled pharmacists on the HF team, noting that medication management is at the core of HF therapy. For instance, HF patients often require drug changes, dose adjustments, and dose titrations.

The authors noted that clinical pharmacists educate patients and care team colleagues, monitor adherence, watch for drug interactions and intolerances, and conduct medication reconciliation during transitions of care.

They also cited studies that demonstrated how pharmacist interventions reduce medication errors, advance patient knowledge, improve treatment adherence, optimize medication use, and decrease

costs. The end result specific to HF is reduced mortality and cardiovascular events.

In clinical practice, leaders need to invest in the multidisciplinary model and develop support systems that ensure teams remain viable, cohesive, and flexible, the authors stressed. Areas of emphasis include resource allocation, acknowledging that 2 groups of patients—those at elevated risk for adverse outcomes and those for whom interventions create the most improvement—will consume a disproportionate share of health care resources.

The clinical stability-to-decompensation cycle can be rapid in HF, so care needs to change in scope and magnitude. Any team-based care model must adapt rapidly to each individual patient’s needs, the authors noted.

The benefits of multidisciplinary care appear obvious, but specific interventions that provide the greatest benefit in HF still need to be identified, and studies that examine various team structure, follow-up intervals, and interventions must be conducted. The current authors projected that individual patients will require unique teams that tailor their approach to care.