A new care model is helping rural heart failure patients get to the right dose of their heart failure medications sooner, and reducing travel for specialist appointments, says cardiologist Dr Daisy Dulay, physician co-chair of the Specialist Services Committee and the project co-lead.
“As a specialist, I’m not able to see patients fast enough to adjust their medications,” says Dr Dulay. “By leveraging the PCN [Primary Care Network] pharmacist—who follows my plan and checks in with me, we save the patients from having to book an extra appointment with me.”
Adjusting heart failure medications is a complex process that involves gradually increasing dosages of four heart failure medications to reach the patient’s most effective dose, while minimizing side effects.
The new care model, supported by the Northern Interior Rural Division of Family Practice, brings together patients, their family physician or nurse practitioner, Dr. Dulay, and the PCN pharmacist for hybrid in-person/virtual visits. The pharmacist provides ongoing medication management and educates the patient about safely increasing drug dosages. This frees up family physicians and nurse practitioners to see other patients. The team is expanding the project to work with three additional PCNs in Northern BC over the next year.
Heart failure is one of the leading causes of hospitalizations in Canada. According to the Heart & Stroke Foundation of Canada, one in five heart failure patients is readmitted to the hospital within one month of discharge. About 750,000 people live with heart failure in Canada, and 100,000 more are diagnosed with it each year.
None of the patients participating in the project experienced adverse events or required an unexpected emergency room visit or hospitalization from the medication changes
About the project:
The project was co-led by Dr Daisy Dulay, cardiologist, and Michael Matula, Northern Interior Rural PCN pharmacist. Dr Dulay is a Clinical Assistant Professor in the Department of Medicine at the University of British Columbia.
This work took place on the lands of the Nadleh Whut’en, Stellat’en, Ts’il Kaz koh, and Saik’uz First Nations communities in the Burns Lake, Fraser Lake, and Vanderhoof area
The work was funded by the Northern Interior Rural Division of Family Practice. The Divisions of Family Practice are funded by the Family Practice Services Committee (FPSC).