{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:11:29Z","timestamp":1780632689859,"version":"3.54.1"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacy"],"abstract":"<jats:p>Discharge prescriptions for heart failure (HF) patients may not adhere to the clinical practice guidelines. This study aimed to assess the impact of the clinical pharmacist as a member of a multidisciplinary team on the quality of prescribing to HF patients at discharge from a Critical Care Unit (CCU) in Egypt. This was a retrospective cohort study of HF patients discharged from the CCU between January 2013 and December 2017. Guideline Adherence Index (GAI-3) was used to assess guideline-directed prescribing at discharge. Multidisciplinary care was introduced to the CCU on 1 January 2016. The study included 284 HF patients, mean (\u00b1SD) age 66.7 \u00b1 11.5 years, 53.2% male. Heart failure with reduced ejection fraction affected 100 patients (35.2%). At discharge, loop diuretics were prescribed to 85.2% of patients; mineralocorticoid receptor antagonists to 54.9%; angiotensin-converting enzyme inhibitors\/angiotensin receptor blockers to 51.4%; and \u03b2-blockers to 29.9%. Population Guideline Adherence Index (GAI-3) was 45.5%. High-GAI was prescribed to 136 patients (47.9%). Patients with High-GAI were younger; less affected by chronic kidney disease and had fewer comorbidities than those without High-GAI. Prescription of \u03b2-blocker increased (24.1% vs. 38.6%, p &lt; 0.001) and digoxin utilization decreased (34.7% vs. 23.7%, p &lt; 0.049) after the introduction of the multidisciplinary care. The inclusion of a clinical pharmacist in the multidisciplinary care team may have a role in optimizing the prescribing of HF guideline-directed therapies at discharge from this setting.<\/jats:p>","DOI":"10.3390\/pharmacy8030159","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T08:53:43Z","timestamp":1598950423000},"page":"159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Heart Failure Prescribing Quality at Discharge from a Critical Care Unit in Egypt: The Impact of Multidisciplinary Care"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0534-3809","authenticated-orcid":false,"given":"Seif","family":"El Hadidi","sequence":"first","affiliation":[{"name":"Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, 30 Cork, Ireland"},{"name":"Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo 11835, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8930-4697","authenticated-orcid":false,"given":"Naglaa","family":"Samir Bazan","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo 11835, Egypt"},{"name":"Critical Care Medicine Department, Cairo University Hospitals, Cairo University, Giza 12511, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Byrne","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, 30 Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebtissam","family":"Darweesh","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo 11835, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Bermingham","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, 30 Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart Disease and Stroke Statistics-2018 Update: A Report from the American Heart Association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ehf2.12005","article-title":"Heart failure: Preventing disease and death worldwide","volume":"1","author":"Ponikowski","year":"2014","journal-title":"ESC Heart Fail."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/ehf2.12021","article-title":"Improving care for patients with acute heart failure: Before, during and after hospitalization","volume":"1","author":"Cowie","year":"2014","journal-title":"ESC Heart Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1093\/eurjhf\/hft050","article-title":"EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)","volume":"15","author":"Maggioni","year":"2013","journal-title":"Eur. 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