{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:50:31Z","timestamp":1791906631989,"version":"4.3.4"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Implementation of guideline\u2010directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) remains incomplete. Non\u2010cardiovascular hospitalization may present opportunities for GDMT optimization. We assessed the efficacy and durability of a virtual, multidisciplinary \u2018GDMT Team\u2019 on medical therapy prescription for HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      Consecutive hospitalizations in patients with HFrEF (ejection fraction \u226440%) were prospectively identified from 3 February to 1 March 2020 (usual care group) and 2 March to 28 August 2020 (intervention group). Patients with critical illness,\n                      <jats:italic>de novo<\/jats:italic>\n                      heart failure, and systolic blood pressure &lt;90\u2009mmHg in the preceeding 24 hs prior to enrollment were excluded. In the intervention group, a pharmacist\u2013physician GDMT Team provided optimization suggestions to treating teams based on an evidence\u2010based algorithm. The primary outcome was a GDMT optimization score, the sum of positive (+1 for new initiations or up\u2010titrations) and negative therapeutic changes (\u22121 for discontinuations or down\u2010titrations) at hospital discharge. Serious in\u2010hospital safety events were assessed. Among 278 consecutive encounters with HFrEF, 118 met eligibility criteria; 29 (25%) received usual care and 89 (75%) received the GDMT Team intervention. Among usual care encounters, there were no changes in GDMT prescription during hospitalization. In the intervention group, \u03b2\u2010blocker (72% to 88%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01), angiotensin receptor\u2013neprilysin inhibitor (6% to 17%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.03), mineralocorticoid receptor antagonist (16% to 29%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.05), and triple therapy (9% to 26%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01) prescriptions increased during hospitalization. After adjustment for clinically relevant covariates, the GDMT Team was associated with an increase in GDMT optimization score (+0.58; 95% confidence interval +0.09 to +1.07;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.02)\n                      <jats:italic>.<\/jats:italic>\n                      There were no serious in\u2010hospital adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010cardiovascular hospitalizations are a potentially safe and effective setting for GDMT optimization. A virtual GDMT Team was associated with improved heart failure therapeutic optimization. This implementation strategy warrants testing in a prospective randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2163","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T03:05:17Z","timestamp":1616727917000},"page":"1191-1201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Virtual optimization of guideline\u2010directed medical therapy in hospitalized patients with heart failure with reduced ejection fraction: the IMPLEMENT\u2010HF pilot study"],"prefix":"10.1093","volume":"23","author":[{"given":"Ankeet S.","family":"Bhatt","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Brigham and Women's Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anubodh S.","family":"Varshney","sequence":"additional","affiliation":[{"name":"Division 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