{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T16:15:34Z","timestamp":1779898534006,"version":"3.53.1"},"reference-count":35,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"4","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"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":["Can Pharm J"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Heart failure with reduced ejection fraction (HFrEF) is a progressive disease with high rates of hospitalization and mortality. The Canadian Cardiovascular Society recommends treating patients with HFrEF with medications from 4 standard medication classes\u2014this is known as guideline-directed medical therapy (GDMT). However, despite clear evidence and recommendations, GDMT agents are known to be underutilized in the HFrEF population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine if the implementation of a prescriber-alert stewardship tool for hospitalized patients with HFrEF will increase the frequency of GDMT prescribing with all classes during hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Utilization of GDMT in patients with HFrEF between admission and discharge pre- and post-implementation of a prescriber alert stewardship tool was compared. Patients admitted to a cardiology stepdown unit between January and April 2022 had a stewardship-alert tool placed on their chart for physician review, while those admitted during the same time frame 1 year prior did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Following the use of a prescriber alert, there was a statistically significant increase in prescribing for \u03b2-blockers (38.1% to 95.2%; p &lt; 0.001), mineralocorticoid receptor antagonists (9.5% to 66.7%; p &lt; 0.001) and combination GDMT (9.5% to 52.4%; p = 0.004) from admission to discharge. A statistically significant increase in the prescribing of \u03b2-blockers (47.6% to 76.2%; p = 0.004) and angiotensin-converting enzyme inhibitors (21.4% to 40.5%; p = 0.008) was still observed without the use of the prescriber alert.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A pharmacist-led heart failure stewardship tool initiative increased uptake of GDMT in patients with HFrEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17151635241249952","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T02:07:17Z","timestamp":1717207637000},"page":"181-189","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["A pharmacist-led heart failure stewardship initiative for guideline-directed medical therapy in hospitalized patients with reduced ejection fraction"],"prefix":"10.3138","volume":"157","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8055-6522","authenticated-orcid":false,"given":"Gemma-Dawn A.","family":"MacDonald","sequence":"first","affiliation":[{"name":"Horizon Health Network, Moncton, New Brunswick"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rochelle M.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Horizon Health Network, Moncton, New Brunswick"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2739-8595","authenticated-orcid":false,"given":"Andrew J.","family":"Flewelling","sequence":"additional","affiliation":[{"name":"Saint John, New Brunswick"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1696","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"bibr1-17151635241249952","volume":"96","author":"Gheorghiade M","year":"2005","journal-title":"Am J Cardiol"},{"key":"bibr2-17151635241249952","unstructured":"Heart and Stoke Foundation of Canada. Falling short: how Canada is failing people with heart failure and how we can change that. 2022. https:\/\/www.heartandstroke.ca\/-\/media\/pdf-files\/canada\/2022-heart-month\/hs-heart-failure-report-2022-final.pdf (accessed 30 Mar. 2024)."},{"key":"bibr3-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000485"},{"key":"bibr4-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.3.344"},{"key":"bibr5-17151635241249952","unstructured":"Canadian Institute for Health Information. Top 5 reasons for hospital stays in Canada. February 2023. Available: https:\/\/www.cihi.ca\/en\/hospital-stays-in-canada (accessed Mar. 16, 2023)."},{"key":"bibr6-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.109.883256"},{"key":"bibr7-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.01.041"},{"key":"bibr8-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10262"},{"key":"bibr9-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.08.074"},{"key":"bibr10-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"bibr11-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.08.022"},{"key":"bibr12-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2021.01.017"},{"key":"bibr13-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-9842(01)00144-1"},{"key":"bibr14-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411001"},{"key":"bibr15-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009492"},{"key":"bibr16-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"bibr17-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911303"},{"key":"bibr18-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051783"},{"key":"bibr19-17151635241249952","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2021.18"},{"key":"bibr20-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30748-0"},{"key":"bibr21-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.08.064"},{"key":"bibr22-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.03.012"},{"key":"bibr23-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.03.007"},{"key":"bibr24-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.6.712"},{"key":"bibr25-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.070"},{"key":"bibr26-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1177\/0897190017747083"},{"key":"bibr27-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2163"},{"key":"bibr28-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.03.338"},{"key":"bibr29-17151635241249952","volume":"353","author":"MERIT-HF Study Group","year":"1999","journal-title":"Lancet"},{"key":"bibr30-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010713"},{"key":"bibr31-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108013250501"},{"key":"bibr32-17151635241249952","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)11181-9"},{"key":"bibr33-17151635241249952","unstructured":"CADTH Common Drug Review. CADTH reimbursement recommendation\u2014empagliflozin (Jardiance). November 2022. Available: https:\/\/www.cadth.ca\/sites\/default\/files\/DRR\/2022\/SR0726%20Jardiance%20-%20Final%20CADTH%20Recommendation.pdf (accessed 15 Mar. 2023)."},{"key":"bibr34-17151635241249952","unstructured":"CADTH Common Drug Review. CADTH Canadian drug expert committee recommendation\u2014dapagliflozin (Foxiga). January 2021. Available: https:\/\/www.cadth.ca\/sites\/default\/files\/cdr\/complete\/SR0642%20Forxiga%20-%20CDEC%20Final%20Recommendation%20January%2021%2C%202021_revised_redacted_for%20posting.pdf (accessed 30 Mar. 2023)."},{"key":"bibr35-17151635241249952","unstructured":"CADTH Common Drug Review. CADTH Canadian drug expert committee recommendation\u2014sacubitril\/valsartan (Entresto). March 2021. Available: https:\/\/www.cadth.ca\/sites\/default\/files\/cdr\/complete\/SR0644%20Entresto%20-%20%20CDEC%20Final%20Recommendation%20March%2026%2C%202021%20%28Redacted%29_for%20Posting.pdf (accessed 30 Mar. 2023)."}],"container-title":["Canadian Pharmacists Journal \/ Revue des Pharmaciens du Canada"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17151635241249952","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17151635241249952","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17151635241249952","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T22:04:49Z","timestamp":1772834689000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17151635241249952"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,31]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1177\/17151635241249952"],"URL":"https:\/\/doi.org\/10.1177\/17151635241249952","relation":{},"ISSN":["1715-1635","1913-701X"],"issn-type":[{"value":"1715-1635","type":"print"},{"value":"1913-701X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,31]]}}}