Identifying unmet needs associated with heart failure patients

Ryan Haumschild, PharmD, MS, MBA: Thank you all for this rich and informative discussion. Before we wrap up, I’d like to hear final thoughts from each of you. dr Murillo, can we begin with your closing thoughts for our viewing audience?

Jaime Murillo, MD: Yes, thank you for the opportunity to discuss the public health approach to treating heart failure, which is a critical patient population that we have. If you think about the population of the United States, the fact that more than 50% of the population is theoretically at risk for heart failure poses great challenges for us to move upstream. Now is the time to think about how best to manage heart failure with guideline-based medical therapy and how to become more proactive and identify those at risk of heart failure and those for consideration in precardiology Fail. Can we optimize strategies to identify patients with better tests? Which population groups are at risk? How can we best use our data to better stratify patients to prevent them progressing to stage D heart failure?

It is important and vital that we approach heart failure in a more optimal way than we have done today, beyond the purely clinical considerations of heart failure management. The key to our success is how we see a patient in their own environment and how we can address that patient with their own needs beyond the regulations.

Ryan Haumschild, PharmD, MS, MBA: Excellent thought: risk stratification, early detection and team-based support. dr Anderson, your final thoughts on us?

John E Anderson, MD: Many Thanks. This was a great discussion. As I look back over the course of my career, where we started and where we are now with heart failure, we have almost a plethora of tools and therapies that we’ve never had before. However, this also comes with increased complexity, especially in the world of primary care where you need to manage multiple different disease states and co-morbidities. Education is critical to ensure everyone understands what guideline-based therapy looks like.

Eventually we have to demolish the silos. So many of these cardio-renal metabolic patients are transcending all of these therapy options that we can no longer be the person who just treats glucose or just treats blood pressure. When you enter the examination room and the patient is sitting in front of you, what does he need? What are they missing? What communication do you need to achieve this?

Ryan Haumschild, PharmD, MS, MBA: Excellent Thoughts. dr Oops, how would you like to end us with some of your final thoughts from today?

Rohit Uppal, MD, MBA, SFH: Those are great final thoughts. People stole my thoughts too. It’s amazing how much today it’s been about team-based mentoring and breaking down silos. Here we are in a telephone conversation where a pharmacist moderates a conversation between a family doctor, a hospital doctor and a cardiologist. Those are the kinds of conversations we need to have. In the course of this conversation, we’ve covered so much ground and made so much progress. We need these kinds of conversations at the community and hospital level. This is how we break down these silos. I’m glad to have been a part of it. Many Thanks.

Ryan Haumschild, PharmD, MS, MBA: Many Thanks. and dr Januzzi, we would like to leave you with a few final thoughts.

Jim Januzzi, MD: There is nothing else to say. This was a great discussion. My colleagues covered all the highlights. Knowing why we do the things we do is useful and important, but learning how we do the things we do is extremely important. To simplify things we have reduced, slightly reduced and conserved ejection fraction. The treatments are largely the same in these different categories. More important is how to start medication, how to titrate the medication, work as a team, and learn how to use those medications. Because with the rising tide of heart failure in the healthcare system, everyone is on deck. Everyone needs to know how to use and use these therapies effectively to reduce the risk to our patients.

Ryan Haumschild, PharmD, MS, MBA: Thanks again for this great discussion. And to our audience, we hope you found this AJMC® peer exchange Discussion as useful and informative.

Transcript edited for clarity.