Comparison of the demographics and clinical characteristics of Heart Failure patients in multidisciplinary clinics with and without a pharmacist involvement

Background: Heart failure (HF) is characterised by high rates of mortality and morbidity, unacceptably high readmission rates, and impaired quality of life. There is emerging evidence that HF patients who receive pharmacist-involved multidisciplinary care have better clinical outcomes. Methods: We conducted a retrospective analysis of two cohorts of HF patients (n = 1148) from a tertiary referral hospital comparing those attending a pharmacist-involved Multidisciplinary Ambulatory Consulting Service (MACS) (n = 723) with the General Cardiology Heart Failure Services (GCHFS) without the pharmacist (n = 461). Cohort data were collected from March 2005 to January 2017. This paper will report demographic and clinical characteristics of the two cohorts. Results: Patients in MACS clinics were typically older and more likely to be female, have heart failure with preserved ejection fraction (HFpEF) (p < 0.001), and higher systolic and diastolic blood pressures. However, we observed similar results for heart rate, and haemoglobin between two groups. GCHFS patients have slightly higher mean ± SD values for serum creatinine. Polypharmacy was higher in MACS patients than in GCHFS (p < 0.001). The prevalence of the major comorbidities including hypertension, ischaemic heart disease, atrial fibrillation, hyperlipidaemia, diabetes, chronic renal disease, chronic obstructive pulmonary disease, depression/anxiety, cardiovascular accident, and cognitive impairment were significantly more common in MACS patients. History of falls, and vitamin D deficiency were significantly higher (p < 0.001) for MACS patients. Conclusions: The presence of a higher proportion of HFpEF cases, polypharmacy, and multiple comorbidities in MACS patients demonstrate the importance of including a clinical pharmacist within the multidisciplinary team.