title: Assessing the potential of e-mail for communicating drug therapy recommendations to physicians in patients with heart failure and ventricular-assist devices.
abstract: OBJECTIVE
  This project explores electronic mail (e-mail) as a potential medium for pharmacists to communicate pharmacotherapy interventions to prescribers.
  
  
  METHODS
  This retrospective descriptive analysis was conducted at an urban, academic teaching hospital. The pharmacist attempted a drug therapy intervention via e-mail when unable to make face-to-face contact with the attending physician. Eligible patients for this project were admitted to the advanced heart failure (HF) team between December 1, 2010, and July 31, 2011, and had at least 1 attempted e-mail intervention. The primary outcome was the number of accepted interventions, while the secondary end point was the time until a physician e-mail response.
  
  
  RESULTS
  A total of 51 e-mail interventions were attempted on 29 patients (mean age = 53, 24% caucasian, 59% male, 69% left ventricular-assist device [VAD]). Overall, of the total 51 interventions,44 (86.3%) were accepted. The average time to a physician e-mail response was 41 minutes. Initiation of drug therapy and changing dose and route or frequency accounted for the most frequent intervention (33%). The most common drug classes involved in the e-mail interventions were angiotensin-converting enzyme inhibitors (15.7%), loop diuretics (9.8%), and antiplatelet agents (7.8%).
  
  
  CONCLUSIONS
  Clinical pharmacists with well-established physician relationships can effectively implement timely drug therapy recommendations using e-mail communications in patients with advanced HF or VADs.
authors: Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA.
authors: Jona
authors: J
authors: Lekura
authors: Department of Pharmacy Services, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA.
authors: Cristina
authors: C
authors: Tita
authors: Department of Pharmacy Services, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA.
authors: David E
authors: DE
authors: Lanfear
authors: Department of Pharmacy Services, Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, USA.
authors: Celeste T
authors: CT
authors: Williams
authors: Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA djennings@nova.edu.
authors: Douglas L
authors: DL
authors: Jennings
mesh_terms: D000046:Academic Medical Centers; D034742:Electronic Mail / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000628:therapy; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010607:Pharmacy Service, Hospital / Q000379:methods*; D010820:Physicians; D012189:Retrospective Studies; D013997:Time Factors
keywords: MTM; clinical pharmacist; e-mail; heart failure; interprofessional communication; intervention; medication therapy management; ventricular-assist devices