Four-Year Evaluation of a Pharmacists-Providers Collaborative Iron Deficiency Clinic in Heart Failure Care

BACKGROUND: Only one-fifth of patients meeting the criteria for intravenous (IV) iron therapy received IV iron in the real-world practice. Pharmacists-providers collaborative iron deficiency (ID) clinic was developed to implement guideline-directed IV iron therapy. OBJECTIVE: To evaluate the 4-year performance of the pharmacists-providers collaborative ID treatment clinic in the heart failure (HF) service. METHODS: A single-center retrospective cohort study was conducted to evaluate the performance of the iron deficiency pharmacists-providers collaborative care clinic during the induction and maintenance phases of IV iron therapy. The study included patients who were seen by HF providers and received the IV iron consultation with HF pharmacists. The study included patients aged 18 years or older who were diagnosed with HF or pulmonary hypertension and received at least 1 dose of IV iron in outpatient settings. It was managed by the pharmacists-providers collaborative IV iron clinic. The primary outcome was adherence to all of the following criteria: the IV iron appropriate use criteria, laboratory requirements, and dosing during the induction course. The use of oral iron therapy was evaluated. RESULTS: A total of 187 patients were included in the final cohort. The median follow-up period of the IV iron consulting team was 372 (176, 623) days. One hundred fifty-two patients (81.3%) were adherent to the appropriate criteria. The most common reasons for nonadherence were the absence of maintenance laboratory requirements (15.5%), failure to administer all induction doses (1.6%), inappropriate use (1.1%), and incorrect dose (0.5%). Among 15 patients on oral iron therapy, the consulting team discontinued it in 3 patients (20.0%) during follow-up. CONCLUSION AND RELEVANCE: The pharmacists-providers collaborative IV iron clinic was effective to implement IV iron therapy in heart failure care settings. These results highlight the importance of multidisciplinary care management for ID in real-world HF practice.