Matches in SemOpenAlex for { <https://semopenalex.org/work/W2890720818> ?p ?o ?g. }
Showing items 1 to 92 of
92
with 100 items per page.
- W2890720818 abstract "Introduction Although optimal pharmacological therapy for heart failure with reduced ejection fraction (HFrEF) is carefully scripted by treatment guidelines, many eligible patients are not treated with guideline-directed medical therapy (GDMT) in clinical practice. We designed a strategy for remote optimization of GDMT on a population scale in patients with HFrEF leveraging non-physician providers. A navigator-led remote medication optimization program will enhance implementation of GDMT in HFrEF patients. Methods An electronic health record-based algorithm was used to identify a cohort of patients with a diagnosis of HF and EF ≤ 40% receiving longitudinal follow up at our center. Those with end-stage HF requiring inotropic support, mechanical circulatory support, or transplantation and those enrolled in hospice or palliative care were excluded. Treating providers were approached for consent to adjust medical therapy according to a sequential, stepped titration algorithm modelled on the current ACC/AHA HF Guidelines. A navigator then facilitated medication adjustments by telephone and conducted longitudinal surveillance of laboratories, blood pressure, and symptoms. Each titration step was reviewed by a pharmacist under supervision of a nurse practitioner and HF cardiologist. Patients were discharged from the program to their primary cardiologist after achievement of an optimal or maximally tolerated regimen. (Figure). Results To date, 615 HFrEF patients have been initially screened for eligibility, of whom 197 (32%) were deemed suitable for remote medication optimization. Further chart review determined 11 (6%) of these patients were already optimized by guidelines. Cardiologists for the remaining 186 patients were approached; provider consent was received for 145 patients (78%). Of these 145 patients, 13 (9%) declined participation, 13 (9%) were unreachable by telephone, and the remaining 119 have been enrolled. Conclusion A navigator-led remote management strategy for optimization of GDMT is feasible for a large proportion of patients with HFrEF and appears acceptable to the vast majority of patients and providers. This approach may represent a scalable population-level strategy for closing the gap between guidelines and clinical practice in patients with HFrEF." @default.
- W2890720818 created "2018-09-27" @default.
- W2890720818 creator A5003740201 @default.
- W2890720818 creator A5005996449 @default.
- W2890720818 creator A5012210095 @default.
- W2890720818 creator A5015481401 @default.
- W2890720818 creator A5016345016 @default.
- W2890720818 creator A5035153052 @default.
- W2890720818 creator A5044740469 @default.
- W2890720818 creator A5048789881 @default.
- W2890720818 creator A5051415966 @default.
- W2890720818 creator A5052863636 @default.
- W2890720818 creator A5072528584 @default.
- W2890720818 creator A5072678416 @default.
- W2890720818 creator A5083580590 @default.
- W2890720818 creator A5087070519 @default.
- W2890720818 creator A5087242254 @default.
- W2890720818 date "2018-08-01" @default.
- W2890720818 modified "2023-09-27" @default.
- W2890720818 title "Navigator-Driven Remote Optimization of Guideline-Directed Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction: Program Design and Initial feasibility" @default.
- W2890720818 doi "https://doi.org/10.1016/j.cardfail.2018.07.379" @default.
- W2890720818 hasPublicationYear "2018" @default.
- W2890720818 type Work @default.
- W2890720818 sameAs 2890720818 @default.
- W2890720818 citedByCount "1" @default.
- W2890720818 countsByYear W28907208182021 @default.
- W2890720818 crossrefType "journal-article" @default.
- W2890720818 hasAuthorship W2890720818A5003740201 @default.
- W2890720818 hasAuthorship W2890720818A5005996449 @default.
- W2890720818 hasAuthorship W2890720818A5012210095 @default.
- W2890720818 hasAuthorship W2890720818A5015481401 @default.
- W2890720818 hasAuthorship W2890720818A5016345016 @default.
- W2890720818 hasAuthorship W2890720818A5035153052 @default.
- W2890720818 hasAuthorship W2890720818A5044740469 @default.
- W2890720818 hasAuthorship W2890720818A5048789881 @default.
- W2890720818 hasAuthorship W2890720818A5051415966 @default.
- W2890720818 hasAuthorship W2890720818A5052863636 @default.
- W2890720818 hasAuthorship W2890720818A5072528584 @default.
- W2890720818 hasAuthorship W2890720818A5072678416 @default.
- W2890720818 hasAuthorship W2890720818A5083580590 @default.
- W2890720818 hasAuthorship W2890720818A5087070519 @default.
- W2890720818 hasAuthorship W2890720818A5087242254 @default.
- W2890720818 hasBestOaLocation W28907208181 @default.
- W2890720818 hasConcept C126322002 @default.
- W2890720818 hasConcept C142724271 @default.
- W2890720818 hasConcept C160735492 @default.
- W2890720818 hasConcept C162324750 @default.
- W2890720818 hasConcept C194828623 @default.
- W2890720818 hasConcept C204787440 @default.
- W2890720818 hasConcept C2778198053 @default.
- W2890720818 hasConcept C2778774980 @default.
- W2890720818 hasConcept C2779326848 @default.
- W2890720818 hasConcept C2779891985 @default.
- W2890720818 hasConcept C2780182762 @default.
- W2890720818 hasConcept C50522688 @default.
- W2890720818 hasConcept C68122502 @default.
- W2890720818 hasConcept C71924100 @default.
- W2890720818 hasConcept C72563966 @default.
- W2890720818 hasConcept C78085059 @default.
- W2890720818 hasConceptScore W2890720818C126322002 @default.
- W2890720818 hasConceptScore W2890720818C142724271 @default.
- W2890720818 hasConceptScore W2890720818C160735492 @default.
- W2890720818 hasConceptScore W2890720818C162324750 @default.
- W2890720818 hasConceptScore W2890720818C194828623 @default.
- W2890720818 hasConceptScore W2890720818C204787440 @default.
- W2890720818 hasConceptScore W2890720818C2778198053 @default.
- W2890720818 hasConceptScore W2890720818C2778774980 @default.
- W2890720818 hasConceptScore W2890720818C2779326848 @default.
- W2890720818 hasConceptScore W2890720818C2779891985 @default.
- W2890720818 hasConceptScore W2890720818C2780182762 @default.
- W2890720818 hasConceptScore W2890720818C50522688 @default.
- W2890720818 hasConceptScore W2890720818C68122502 @default.
- W2890720818 hasConceptScore W2890720818C71924100 @default.
- W2890720818 hasConceptScore W2890720818C72563966 @default.
- W2890720818 hasConceptScore W2890720818C78085059 @default.
- W2890720818 hasLocation W28907208181 @default.
- W2890720818 hasOpenAccess W2890720818 @default.
- W2890720818 hasPrimaryLocation W28907208181 @default.
- W2890720818 hasRelatedWork W1966832362 @default.
- W2890720818 hasRelatedWork W1993262423 @default.
- W2890720818 hasRelatedWork W2081059952 @default.
- W2890720818 hasRelatedWork W2160476190 @default.
- W2890720818 hasRelatedWork W2596233504 @default.
- W2890720818 hasRelatedWork W2734943774 @default.
- W2890720818 hasRelatedWork W2890720818 @default.
- W2890720818 hasRelatedWork W3107163751 @default.
- W2890720818 hasRelatedWork W3207470265 @default.
- W2890720818 hasRelatedWork W2776948271 @default.
- W2890720818 isParatext "false" @default.
- W2890720818 isRetracted "false" @default.
- W2890720818 magId "2890720818" @default.
- W2890720818 workType "article" @default.