Pharmacotherapy
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There has been a 10-year hiatus in the approval of a new pharmacotherapy for patients with chronic heart failure with a reduced ejection fraction (HFrEF). Combining an angiotensin receptor blocker, valsartan, with sacubitril, an inhibitor of neprilysin, results in increasing levels of natriuretic peptides that counterbalance high circulating levels of neurohormones in HFrEF. This has resulted in the development of a new agent, LCZ696. A comprehensive overview of LCZ696, its pharmacology, its role in the pathophysiology of HFrEF, completed and future clinical trial information, specific critical issues, and the place of LCZ696 in HFrEF therapy are presented.
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Project Re-Engineered Discharge is a discharge nurse education (DNE) and pharmacist follow-up telephone intervention protocol that was shown to decrease rehospitalization significantly. The specific value of the pharmacist intervention was not originally evaluated. The objective of this study was to determine the impact of a pharmacist telephone intervention during the transition of care process on the rate of unplanned hospitalization within 30 days of patient discharge. ⋯ Patients unable to be contacted by a pharmacist after hospital discharge were more likely to be readmitted or visit the emergency department in the 30 days following discharge. A pharmacist telephone intervention as part of a comprehensive discharge protocol can have a positive impact on patients during the transition of care process by reducing incidence of unplanned hospital utilization.