SynthesisJournal of cardiac failure2023
Pharmacist- and Nurse-Led Medical Optimization in Heart Failure: A Systematic Review and Meta-Analysis.
Synthesis in Journal of cardiac failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07490470 (A Nurse-Led, Multidisciplinary mHealth Program to Manage Heart Failure During the Vulnerable Post-Discharge Period), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Nurse-Led, Multidisciplinary mHealth Program to Manage Heart Failure During the Vulnerable Post-Discharge Period
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Pooled it
- Economic Modeling Analysis of an Intensive GDMT Optimization Program in Hospitalized Heart Failure Patients.Circulation. Heart failure · 2023Trial
- Initiation, Adherence, and Persistence to Guideline-Directed Medical Therapy After Heart Failure Hospitalization.JAMA internal medicine · 2026Article
- Building Collaborative Heart Failure Care Through a Community Pharmacy Certificate Program and Community Pharmacist-Physician Network.JACC. Advances · 2026Article
- Drug Adherence After Hospitalisation for Heart Failure: What Have We Learned from a French Survey?Journal of clinical medicine · 2026Article
- Correction to: Hyperkalemia in heart failure with reduced ejection fraction: implications and management.Heart failure reviews · 2026Article
- Changes in Clinician Telemedicine Use and Care Patterns for Patients With Heart Failure in the United States.Circulation. Population health and outcomes · 2026Article
- Optimizing Heart Failure-Specific Disease Management Programs and Patient Care in Saudi Arabia: A Saudi Heart Association Position Statement.Journal of the Saudi Heart Association · 2026Article
- Nurse-coordinated multidisciplinary comprehensive heart failure management programme: A propensity-matched trial.ESC heart failure · 2025Article
- Predicted Mortality and Cardiology Follow-up Following Heart Failure Hospitalizations Among Veterans Health Administration Patients.Journal of cardiac failure · 2025Article
- Pharmacist-led guideline-directed medical therapy in heart failure: impact analysis in primary care.BMJ open quality · 2025Article
- Direct-to-Physician Marketing and Uptake of Optimal Medical Therapy for Heart Failure With Reduced Ejection Fraction.JACC. Heart failure · 2025Article
- Closing the GDMT gap: insights from PHARM-HF A&F on the role of pharmacists in heart failure care.Heart failure reviews · 2025Review
- Examining the clinical role and educational preparation of heart failure nurses across Europe. A survey of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC.European journal of heart failure · 2025Article
- Changing the paradigm in heart failure: shifting from treatment to prevention.Heart failure reviews · 2025Review
- Pharmacist Medication Titration Program for Patients With Cardiac Sarcoidosis and Systolic Heart Failure: A Retrospective Cohort Study.Journal of the American Heart Association · 2024Article
- Digital health as a tool for patient activation and improving quality of care for heart failure.Heart failure reviews · 2024Review
- Medication optimization clinic decreases hospitalizations and mortality for patients with heart failure with reduced ejection fraction.American heart journal plus : cardiology research and practice · 2024Article
- Review
- Protocol-driven approach to guideline-directed medical therapy optimization for heart failure: A real-world application to recovery.American heart journal plus : cardiology research and practice · 2024Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundTraditional approaches to guideline-directed medical therapy (GDMT) management often lead to delayed initiation and titration of therapies in patients with heart failure. This study sought to characterize alternative models of care involving nonphysician provider-led GDMT interventions and their associations with therapy use and clinical outcomes.
methodsWe performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies comparing nonphysician provider-led GDMT initiation and/or uptitration interventions vs usual physician care (PROSPERO ID: CRD42022334661). We queried PubMed, Embase, the Cochrane Library, and the World Health Organization International Clinical Trial Registry Platform for peer-reviewed studies from database inception to July 31, 2022. In the meta-analysis, we used RCT data only and leveraged random-effects models to estimate pooled outcomes. Primary outcomes were GDMT initiation and titration to target dosages by therapeutic class. Secondary outcomes included all-cause mortality and HF hospitalizations.
resultsWe reviewed 33 studies, of which 17 (52%) were randomized controlled trials with median follow-ups of 6 months; 14 (82%) trials evaluated nurse interventions, and the remainder assessed pharmacists' interventions. The primary analysis pooled data from 16 RCTs, which enrolled 5268 patients. Pooled risk ratios (RR) for renin-angiotensin system inhibitor (RASI) and beta-blocker initiation were 2.09 (95% CI 1.05-4.16; I
conclusionsPharmacist- and nurse-led interventions for GDMT initiation and/or uptitration improved guideline concordance. Further research evaluating newer therapies and titration strategies integrated with pharmacist- and/or nurse-based care may be valuable.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.