Article: Reducing Readmissions for Heart Failure Patients

One in four heart failure patients are readmitted within 30 days of hospital discharge...often due to medication-related problems.

But early follow-up from you...their pharmacist...can help.

For example, talking with patients within 2 days of discharge PLUS an office visit within 7 days prevents one ED visit for every 9 heart failure patients...and one readmission for every 52 patients.

Expect to see more hospitals, prescribers, and payers looking to work with YOU to help reduce readmissions.

Your expertise can improve care...and save money. Think of your role managing heart failure as similar to managing anticoag patients. There'll be professional and financial opportunity in it.

Offer comprehensive med reviews to identify and resolve problems.

Recommend an ACEI or ARB plus an "evidence-based" beta-blocker...bisoprolol, carvedilol, or metoprolol SUCCINATE...for systolic heart failure. Suggest adding an aldosterone antagonist if symptoms persist.

Recommend trying to titrate to target doses that improve survival, such as lisinopril 20 to 40 mg/day or metoprolol succinate 200 mg/day.

Consider suggesting Entresto (sacubitril/valsartan) instead of the ACEI or ARB if hospitalization occurs despite use of target doses. But be aware of hypotension, and avoid Entresto when systolic BP < 100 mmHg.

Educate patients about self-management...and when to get help. Include caregivers...they are crucially important to success in many cases.

Consider using a heart failure questionnaire from our PL Detail-Document to identify red flags BEFORE patients get worse. For example, advise patients to report if weight changes by more than a few pounds.

Emphasize adherence with meds, limiting fluids, diet, etc. For example, help patients understand how taking their ACEI or ARB improves their outcomes. Plus this also impacts Star Ratings.

Suggest pillboxes or consider offering med sync to boost adherence. Use our PL Conversation Starter to guide your discussions.

Communicate with colleagues if you find problems with med lists or identify adherence issues...to prevent gaps in therapy.