Does the Interpretation of Fluid Threshold Crossings Differ between Heart Failure and Non Heart Failure Centers? Analysis from the OptiVol Care Pathway Study

Abstract

medication education and counseling (92% of programs), reconciliation between discharge & community medication lists (92%), adherence assessment (75%), check of non-prescription medications (75%), facilitated communication about medications between health care professionals (67%), provision of in-depth medication review (50%) & dosage aids (42%). The majority of medication interventions were provided by nurses and all but one program had access to a pharmacist, usually based in the hospital pharmacy department. Only 40% of the programs evaluated program effectiveness. The lack of a dedicated pharmacist and inadequate information transfer across health care settings were noted to be barriers in the achievement of QUM. Respondents cited lack of funding & lack of recognition by administrators determining business plans as major barriers to establishment of medication management services. Conclusions: QUM in HF is challenging. Its importance in HF programs has been recognised, however, content varies. Standardised processes for medication management, assessment of adherence and medication reviews are important in facilitating optimal HF outcomes. Improving information exchange and increasing the numbers of dedicated pharmacists is also recommended.