Abstract 14162: An Observational Study of Guideline-Directed Medical Therapy Optimization for Patients With Heart Failure With Reduced Ejection Fraction in Telehealth versus In-Person Visits
Abstract
Introduction:
Rates of initiation and dose optimization of guideline-directed medical therapy (GDMT) for heart failure patients with reduced ejection fraction are suboptimal nationally. Recently, virtual medicine has been studied as a potential solution to help overcome barriers limiting GDMT optimization. We evaluated GDMT optimization during telehealth visits compared with in-person visits at Parkland Health, a large urban safety-net health system.
Methods:
Parkland has a registry of all patients with an ejection fraction
≤
40% on transthoracic echocardiography within the last three years. Using this registry data of patients seen in the Parkland cardiology clinic between September 2021 and February 2022, we compared GDMT prescriptions for patients before and after each clinic visit. We defined an optimization event as the initiation of a new class of GDMT, a switch to an angiotensin receptor/neprilysin inhibitor, or an increase in dosage of any class of GDMT. The rise of Omicron variant COVID-19 cases in Dallas led to a nearly universal shift of in-person to virtual visits in December 2021, allowing us to compare GDMT optimization rates between each visit type.
Results:
From 9/12/21 to 12/24/21, there were 147 visits of which 134 (91%) were in-person. Of these in-person visits, 58.2% led to an optimization event. From 12/25/21 to 2/12/22, there were 97 visits of which 84 (89%) were telehealth visits, all conducted by telephone. Of these telehealth visits, 16.1% led to an…
Read the paper
Related studies
- Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
- A meta‐analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale
- Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
- Exercise interventions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials
- Prognostic Significance of Carbonic Anhydrase IX Expression in Cancer Patients: A Meta-Analysis
- Glucocorticoid Resistance: Is It a Requisite for Increased Cytokine Production in Depression? A Systematic Review and Meta-Analysis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.