Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study

Background: Given rising morbidity, mortality, and costs due to heart failure (HF), new approaches for prevention are needed. A quantitative risk-based strategy, in line with established guidelines for atherosclerotic cardiovascular disease prevention, may efficiently select patients most likely to...

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Autores principales:	Michael C. Wang, Bridget Dolan, Benjamin H. Freed, Lourdes Vega, Nikola Markoski, Amy E. Wainright, Bonnie Kane, Laura E. Seegmiller, Katharine Harrington, Alana A. Lewis, Sanjiv J. Shah, Clyde W. Yancy, Ian J. Neeland, Hongyan Ning, Donald M. Lloyd-Jones, Sadiya S. Khan
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	heart failure primary prevention pharmacist risk prediction natriuretic peptides Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/dfeb147630e34784acc3441563cfae36
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spelling	oai:doaj.org-article:dfeb147630e34784acc3441563cfae362021-12-01T13:34:57ZRationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study2297-055X10.3389/fcvm.2021.785109https://doaj.org/article/dfeb147630e34784acc3441563cfae362021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.785109/fullhttps://doaj.org/toc/2297-055XBackground: Given rising morbidity, mortality, and costs due to heart failure (HF), new approaches for prevention are needed. A quantitative risk-based strategy, in line with established guidelines for atherosclerotic cardiovascular disease prevention, may efficiently select patients most likely to benefit from intensification of preventive care, but a risk-based strategy has not yet been applied to HF prevention.Methods and Results: The Feasibility of the Implementation of Tools for Heart Failure Risk Prediction (FIT-HF) pilot study will enroll 100 participants free of cardiovascular disease who receive primary care at a single integrated health system and have a 10-year predicted risk of HF of ≥5% based on the previously validated Pooled Cohort equations to Prevent Heart Failure. All participants will complete a health and lifestyle questionnaire and undergo cardiac biomarker (B-type natriuretic peptide [BNP] and high-sensitivity cardiac troponin I [hs-cTn]) and echocardiography screening at baseline and 1-year follow-up. Participants will be randomized 1:1 to either a pharmacist-led intervention or usual care for 1 year. Participants in the intervention arm will undergo consultation with a pharmacist operating under a collaborative practice agreement with a supervising cardiologist. The pharmacist will perform lifestyle counseling and recommend initiation or intensification of therapies to optimize risk factor (hypertension, diabetes, and cholesterol) management according to the most recent clinical practice guidelines. The primary outcome is change in BNP at 1-year, and secondary and exploratory outcomes include changes in hs-cTn, risk factor levels, and cardiac mechanics at follow-up. Feasibility will be examined by monitoring retention rates.Conclusions: The FIT-HF pilot study will offer insight into the feasibility of a strategy of quantitative risk-based enrollment into a pharmacist-led prevention program to reduce heart failure risk.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT04684264Michael C. WangBridget DolanBenjamin H. FreedLourdes VegaNikola MarkoskiAmy E. WainrightBonnie KaneLaura E. SeegmillerKatharine HarringtonAlana A. LewisSanjiv J. ShahSanjiv J. ShahClyde W. YancyIan J. NeelandIan J. NeelandHongyan NingDonald M. Lloyd-JonesDonald M. Lloyd-JonesSadiya S. KhanSadiya S. KhanFrontiers Media S.A.articleheart failureprimary preventionpharmacistrisk predictionnatriuretic peptidesDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	heart failure primary prevention pharmacist risk prediction natriuretic peptides Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	heart failure primary prevention pharmacist risk prediction natriuretic peptides Diseases of the circulatory (Cardiovascular) system RC666-701 Michael C. Wang Bridget Dolan Benjamin H. Freed Lourdes Vega Nikola Markoski Amy E. Wainright Bonnie Kane Laura E. Seegmiller Katharine Harrington Alana A. Lewis Sanjiv J. Shah Sanjiv J. Shah Clyde W. Yancy Ian J. Neeland Ian J. Neeland Hongyan Ning Donald M. Lloyd-Jones Donald M. Lloyd-Jones Sadiya S. Khan Sadiya S. Khan Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study
description	Background: Given rising morbidity, mortality, and costs due to heart failure (HF), new approaches for prevention are needed. A quantitative risk-based strategy, in line with established guidelines for atherosclerotic cardiovascular disease prevention, may efficiently select patients most likely to benefit from intensification of preventive care, but a risk-based strategy has not yet been applied to HF prevention.Methods and Results: The Feasibility of the Implementation of Tools for Heart Failure Risk Prediction (FIT-HF) pilot study will enroll 100 participants free of cardiovascular disease who receive primary care at a single integrated health system and have a 10-year predicted risk of HF of ≥5% based on the previously validated Pooled Cohort equations to Prevent Heart Failure. All participants will complete a health and lifestyle questionnaire and undergo cardiac biomarker (B-type natriuretic peptide [BNP] and high-sensitivity cardiac troponin I [hs-cTn]) and echocardiography screening at baseline and 1-year follow-up. Participants will be randomized 1:1 to either a pharmacist-led intervention or usual care for 1 year. Participants in the intervention arm will undergo consultation with a pharmacist operating under a collaborative practice agreement with a supervising cardiologist. The pharmacist will perform lifestyle counseling and recommend initiation or intensification of therapies to optimize risk factor (hypertension, diabetes, and cholesterol) management according to the most recent clinical practice guidelines. The primary outcome is change in BNP at 1-year, and secondary and exploratory outcomes include changes in hs-cTn, risk factor levels, and cardiac mechanics at follow-up. Feasibility will be examined by monitoring retention rates.Conclusions: The FIT-HF pilot study will offer insight into the feasibility of a strategy of quantitative risk-based enrollment into a pharmacist-led prevention program to reduce heart failure risk.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT04684264
format	article
author	Michael C. Wang Bridget Dolan Benjamin H. Freed Lourdes Vega Nikola Markoski Amy E. Wainright Bonnie Kane Laura E. Seegmiller Katharine Harrington Alana A. Lewis Sanjiv J. Shah Sanjiv J. Shah Clyde W. Yancy Ian J. Neeland Ian J. Neeland Hongyan Ning Donald M. Lloyd-Jones Donald M. Lloyd-Jones Sadiya S. Khan Sadiya S. Khan
author_facet	Michael C. Wang Bridget Dolan Benjamin H. Freed Lourdes Vega Nikola Markoski Amy E. Wainright Bonnie Kane Laura E. Seegmiller Katharine Harrington Alana A. Lewis Sanjiv J. Shah Sanjiv J. Shah Clyde W. Yancy Ian J. Neeland Ian J. Neeland Hongyan Ning Donald M. Lloyd-Jones Donald M. Lloyd-Jones Sadiya S. Khan Sadiya S. Khan
author_sort	Michael C. Wang
title	Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study
title_short	Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study
title_full	Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study
title_fullStr	Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study
title_full_unstemmed	Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study
title_sort	rationale and design of a pharmacist-led intervention for the risk-based prevention of heart failure: the fit-hf pilot study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/dfeb147630e34784acc3441563cfae36
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Rationale and Design of a Pharmacist-led Intervention for the Risk-Based Prevention of Heart Failure: The FIT-HF Pilot Study

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