Enlisting pharmacists and nurse practitioners in medication management can fill critical gaps

by Elsevier

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A novel economic model projects that patients with heart failure would live longer and spend less time in the hospital by expanding heart failure care to include pharmacist- and nurse practitioner-led medication management. Findings from the novel study in the Canadian Journal of Cardiology demonstrate the cost-effectiveness of this service and offer a roadmap toward improved patient outcomes and a stronger, more sustainable health care system.

Heart failure affects approximately 860,000 Canadians, is associated with reduced survival and quality of life, and is the third-leading cause of hospitalization in the country. Heart failure with reduced ejection fraction (HFrEF) accounts for approximately half of these cases.

Despite high-quality evidence supporting the benefits of guideline-directed medical therapy (GDMT) for patients with HFrEF, which entails the rapid initiation of four distinct classes of medication collectively known as quadruple therapy, use of these medications remains suboptimal. This is partly due to inadequate access to heart failure specialists and clinics for many Canadian patients living with HFrEF. This high unmet need underscores the importance of alternative models that expand beyond physician-led GDMT management.

"Heart failure is a serious medical condition that has several effective medications that are underused across Canada," says lead investigator Ricky Turgeon, BSc(Pharm), ACPR, PharmD, Faculty of Pharmaceutical Sciences, University of British Columbia. "Pharmacists and nurse practitioners are important members of the health care team who can help improve medication use for heart failure."

The researchers evaluated whether having pharmacists and nurse practitioners initiate and manage heart failure medications would be a good value for money for the health care system by comparing two different scenarios using an economic model.

In the first scenario, patients with heart failure received the usual care currently experienced by most British Columbians with heart failure. In the second scenario, patients with heart failure received the usual care plus additional medication management from pharmacists and nurse practitioners.

The investigators then modeled what would happen to these patients over time and tracked how long they would live, how often they would be hospitalized, and how many health care resources they would need.

It was estimated that within the first year of implementation, this added service would save approximately 10 lives and prevent 25 hospitalizations for every 1,000 patients who received the pharmacist- or nurse practitioner-led intervention.

"While this service would require additional funding, we demonstrated that this investment would be well justified given what the Canadian health care system is generally willing to pay," notes Turgeon.

"The size of this benefit was far beyond what was anticipated. As a pharmacist caring for people with heart failure, I find these results genuinely empowering. They show that we play an important role in improving patients' lives while also easing pressure on the health care system. We have the evidence; now we need to implement this approach."

By quantifying the clinical and economic impacts of these additional medication management services, this study provides health care system planners with the insights needed to effectively address persistent gaps in care for heart failure patients.

Co-lead investigator Kelly Mackay, MA, Cardiac Services BC, Provincial Health Services Authority, comments, "Our research offers a roadmap to improving patient outcomes while strengthening the sustainability of our health system. The research also provides Cardiac Services BC with the evidence and innovation needed to drive meaningful system change."

"Expedited and increased access to quadruple therapy has the potential to save lives and reduce some of the pressures in British Columbia's hospitals. We believe this model could also be successful in other Canadian provinces. We're thrilled that this research presents such an effective—and feasible—way for more heart failure patients to receive this gold-standard treatment," concludes co-investigator Nathaniel Hawkins, MBChB, MD, MPH, Cardiac Services BC, Provincial Health Services Authority, and Division of Cardiology, University of British Columbia.

Publication details

Cost-effectiveness of Pharmacist and Nurse Practitioner-led Medication Management for Heart Failure With Reduced Ejection Fraction, Canadian Journal of Cardiology (2026). DOI: 10.1016/j.cjca.2026.05.001

Journal information: Canadian Journal of Cardiology

Key medical concepts

Heart FailureHeart failure with reduced ejection fraction

Clinical categories

CardiologyAllied health Provided by Elsevier Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Robert Egan

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Citation: Enlisting pharmacists and nurse practitioners in medication management can fill critical gaps (2026, June 29) retrieved 29 June 2026 from https://medicalxpress.com/news/2026-06-pharmacists-nurse-practitioners-medication-critical.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.