Publications by authors named "Taylor E MacLean"
Article Synopsis
- A study at a large academic medical center aimed to identify the reasons behind the underutilization and under-dosing of guideline-directed medical therapies (GDMT) in patients with heart failure with reduced ejection fraction (HFrEF).
- Out of 500 patients analyzed, many were prescribed recommended medications like ACE inhibitors and beta blockers, but only a small percentage received the optimal doses, with lower rates for other treatment types such as MRAs and ARNi.
- The reasons for this lack of optimal medication usage were often unclear from medical records and patient discussions, indicating a potential quality-of-care issue rather than patient-specific factors like intolerance or contraindications.
Although optimal pharmacological therapy for heart failure with reduced ejection fraction (HFrEF) is carefully scripted by treatment guidelines, many eligible patients are not treated with guideline-directed medical therapy (GDMT) in clinical practice. We designed a strategy for remote optimization of GDMT on a population scale in patients with HFrEF leveraging nonphysician providers. An electronic health record-based algorithm was used to identify a cohort of patients with a diagnosis of heart failure (HF) and ejection fraction (EF) ≤ 40% receiving longitudinal follow-up at our center.
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- The study discusses enhancing patient recruitment for clinical trials by using electronic health records (EHR) to refine patient eligibility through a method called phenotyping, optimizing the traditional manual screening approach.
- The process involves multiple cycles where each cycle uses a phenotyping algorithm to generate a prioritized list of eligible patients, followed by manual screening and results analysis to improve the next cycle.
- The results indicated that 23% of screened patients were eligible, and the iterative approach significantly improved the positive screening rate compared to a static approach, suggesting the potential for better recruitment strategies in clinical studies going forward.*