Abstract 16069: Patient Education and Medication Checklists for Optimization of Guideline-Directed Medical Therapy

Abstract

Introduction: Despite strong evidence on the benefits of guideline-directed medical therapies (GDMT) in patients with heart failure with reduced ejection fraction (HFrEF), the use of GDMT remains suboptimal in clinical practice. Hypothesis: We hypothesized that patient educational videos, coupled with an interactive medication checklist provided to patients, would improve prescription of GDMT in outpatient cardiology clinics. Methods: Patients over the age of 18 years with a diagnosis of HFrEF and a cardiology clinic appointment during the study period were included. Electronic health record communications were sent to patients the week prior to their scheduled cardiology appointments. The communication included (1) short videos on GDMT and (2) a medication checklist to be completed by the patient and brought to their upcoming appointment. The primary outcomes were initiation and uptitration of GDMT. Results: A total of 253 patients (mean age 67 +/- 14 years) were included, of which 69% were male, 10% black, and 11% Hispanic. At baseline, 86% of patients were on an evidence-based beta-blocker, but only 17% were at goal doses (Figure). Additionally, only half of eligible patients were on a mineralocorticoid receptor antagonist (MRA) or sodium-glucose cotransporter-2 inhibitor (SGLT2i). Post-intervention, there was a significant increase in the number of patients on a renin-angiotensin-aldosterone inhibitor (75.9% to 78.3%, p=0.04) and SGLT2i (50.2% to 52.7%, p=0.04). There was also a 0.8% increase in the number of patients on target doses of MRAs, although this did not reach statistical significance. Conclusions: Educational materials and checklists provided to patients prior to clinic appointments were associated with improved initiation and uptitration of GDMT. This intervention may be a scalable and low-cost way of engaging patients in their medical care and encouraging shared decision making, although further study is needed.