{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:30:28Z","timestamp":1782451828953,"version":"3.54.5"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T00:00:00Z","timestamp":1649289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:p>Background: Heart failure guidelines recommend replacing an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) with an angiotensin receptor neprilysin inhibitor (ARNI) to reduce morbidity and mortality in NYHA Class II\u2013III patients with reduced ejection fraction (HFrEF). Objective: This study aims to determine if a pharmacist-led outpatient ARNI replacement and titration program led to more patients achieving target doses of ARNI compared to usual care. Methods: A single health system, retrospective electronic medical record review identified 791 patients with active ARNI prescriptions and at least two outpatient cardiology visits with a pharmacist or usual care provider between January 2015 through September 2018. The primary outcome was the percentage of patients who achieved a target ARNI dose of 97\/103\u00a0mg twice daily. The secondary outcomes were the median dose achieved, number of visits required to achieve target dose, hospitalizations, and all-cause death. Results: ARNI was initiated and continued by a pharmacist in 64 patients and 727 by usual care. More patients in the pharmacist group, 60.9% (n = 39), achieved target dose vs. 18.0% (n = 131) of patients managed by usual care (95% CI, 0.31\u20130.55, p &lt; 0.0001). The pharmacist group also had higher median total daily dose of ARNI (200\u00a0mg (IQR = 300) vs 100\u00a0mg (IQR = 100), p &lt; 0.0001) and more likely to achieve a higher total daily dose in fewer visits. Conclusions: An advanced practice provider pharmacist-led outpatient ARNI replacement and titration program was more effective in achieving target doses of ARNI in HFrEF patients as compared to usual care.<\/jats:p>","DOI":"10.1177\/08971900221087087","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T23:57:36Z","timestamp":1649375856000},"page":"1061-1067","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A Retrospective Cohort Evaluation of a Pharmacist-Led Approach for Transitioning Patients to an Angiotensin Receptor\u2014Neprilysin Inhibitor"],"prefix":"10.1177","volume":"36","author":[{"given":"Krishna","family":"Rana","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Durham Veterans Affairs Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Jay","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonalie","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-057X","authenticated-orcid":false,"given":"Carla","family":"Sueta","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6039-0125","authenticated-orcid":false,"given":"Zack","family":"Deyo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of North Carolina Hospitals, Chapel Hill, NC, USA"},{"name":"Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"bibr1-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"bibr2-08971900221087087","unstructured":"Heart Failure. Centers for Disease Control and Prevention. https:\/\/www.cdc.gov\/heartdisease\/heart_failure.htm?CDC_AA_refVal=https:\/\/www.cdc.gov\/dhdsp\/data_statistics\/fact_sheets\/fs_heart_failure.htm Published December 9, 2019. Accesssed February 2, 2020."},{"key":"bibr3-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31829e8776"},{"key":"bibr4-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"bibr5-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.022"},{"key":"bibr6-08971900221087087","unstructured":"Heidenreich PA, Fonarow GC, Breathett K, et al. ACC\/AHA clinical performance and quality measures for adults with heart failure. 2020 ACC\/AHA heart failure measures. https:\/\/americanheart.co1.qualtrics.com\/CP\/File.php?F=F_byc1SsvnIqUJeT3. Published January 31, 2020. Accessed February 2, 2020."},{"key":"bibr7-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1161\/circheartfailure.118.005035"},{"key":"bibr8-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.070"},{"key":"bibr9-08971900221087087","volume-title":"Entresto (Sacubitril and Valsartan) [Package Insert]","year":"2019"},{"key":"bibr10-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1080\/02813432.2017.1397253"},{"key":"bibr11-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.014281"},{"key":"bibr12-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2019.07.455"},{"key":"bibr13-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2008.02.011"},{"key":"bibr14-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(01)00165-3"},{"key":"bibr15-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-018-0264-5"},{"key":"bibr16-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.16.1939"},{"key":"bibr17-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.7.687"},{"key":"bibr18-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1177\/1060028017698974"},{"key":"bibr19-08971900221087087","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.04.001"},{"key":"bibr20-08971900221087087","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2018-039"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900221087087","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900221087087","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900221087087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:37:23Z","timestamp":1777509443000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900221087087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,7]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1177\/08971900221087087"],"URL":"https:\/\/doi.org\/10.1177\/08971900221087087","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,7]]}}}