title: Comparison of chronic systolic heart failure guideline adherence for two ambulatory clinics.
abstract: Guidelines have been published for management of chronic systolic heart failure to reduce patient morbidity and mortality.
  
  
  OBJECTIVE
  A quality review of the heart failure medical therapy for a community family medicine residency program clinic and a multidisciplinary heart failure specialty clinic was performed to compare adherence to ACC/AHA heart failure guidelines, with regard to medications and in titrating to recommended target doses.
  
  
  METHODS
  The study was a retrospective chart review and data collected included name and dose of any ACEI, beta-blocker, ARB, or other medication addressed in the guidelines.
  
  
  RESULTS
  Specialty clinic patients had significantly lower systolic blood pressures and ejection fractions. Significantly more patients were prescribed beta-blockers in the specialty clinic population (98% vs 80%, p<0.05). Both patient populations had very low rates of reaching target beta-blocker doses (15% vs 21%, p=0.27). More patients in the family medicine clinic reached target doses of ACEI (64% vs 49%, p<0.05) and ARBs (67% vs 35%, p<0.05).
  
  
  CONCLUSIONS
  This study revealed the vast majority of patients in either a community family medicine residency program or heart failure specialty clinic were prescribed ACEI or ARB, and beta-blockers. However, achieving target doses should continue to be an important goal for practitioners.
authors.affiliation: Department Clinical Pharmacist. University of Utah , Department of Pharmacy Services. Salt Lake City, UT ( United States ).
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Dehoney
authors.affiliation: Associate Residency Program Director, Trident/MUSC Family Medicine Residency Program. Medical University of South Carolina. Charleston, SC ( United States ).
authors.forename: Lori M
authors.initials: LM
authors.lastname: Dickerson
authors.affiliation: South Carolina College of Pharmacy-MUSC Campus. Professor of Medicine, Medical University of South Carolina . Charleston, SC ( United States ).
authors.forename: Jean M
authors.initials: JM
authors.lastname: Nappi
keywords: Drug Therapy; Guideline Adherence; Heart Failure; Systolic; United States