Implementation of a Heart Failure Trajectory Smart Phrase in the EMR Increases Rates of Guideline Directed Medical Therapy at Discharge

Publication Title

American College of Cardiology Annual Scientific Session and Expo, April 6-8, 2024, Atlanta, GA

Document Type

Abstract

Publication Date

4-2024

Keywords

oregon; cards; cards publication

Abstract

Background

Our goal was to operationalize the 2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical Trajectory of the Hospitalized Heart Failure (HF) Patient.

Methods

In March 2022, we implemented an EMR smartphrase identifying HF patient's daily trajectory (improving, stalled, or worsening) and documenting appropriate interventions and escalation of care. The smartphrase captured clinical data; coupled with patient assessment, providers were prompted to address diuretic management, guideline directed medical therapy (GDMT), and consultations. Extensive training on the ACC pathway, smartphrase, GMDT, and standard trajectory language was delivered to cardiology and hospitalist providers and cardiology nursing staff. Data on smartphrase utilization and outcomes was collected at 5-month intervals.

Results

The trajectory smartphrase project showed the most significant effect on prescribing patterns of GDMT. Although the prescriptions for beta-blockers and ACEi/ARB/ARNi were not significantly different (≤ 6%) whether the smart phrase was used or not, mineralocorticoids (MRA) and sodium glucose cotransporter 2 inhibitors (SGLT2i) prescribing improved significantly when the smartphrase was used vs not used [SGLT2i: 78% vs 36%, p=.0042 (Aug 2022); 97% vs 46%, p<.0001 (Jan 2023); MRA: 79% vs 35%, p=.0020 (Aug 2022); 81% vs 36%, p=.0027 (Jan 2023)].

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Conclusion

Use of the HF Trajectory Smartphrase improved prescribing of GDMT in hospitalized HF patients.

Footnotes

Poster Contributions

Hall B4-5

Saturday, April 6, 2024, 1:45 p.m.-2:30 p.m.

Session Title: 1284: Heart Failure and Cardiomyopathies: Pharmacology 05

Abstract Category: 07. Heart Failure and Cardiomyopathies: Pharmacology

Presentation Number: 1284-125

Area of Special Interest

Cardiovascular (Heart)

Specialty/Research Institute

Cardiology

Specialty/Research Institute

Nursing

Specialty/Research Institute

Hospital Medicine

DOI

10.1016/S0735-1097(24)02477-X


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