Advances in the treatment of chronic heart failure with reduced ejection fraction in real-world settings

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2 CPD/CME credits, 2 hours
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Sponsorship Statement:

This sponsored supplement was initiated and funded by Novartis Pharmaceuticals UK Ltd. Editorial control, however, was retained by the authors and editors but Novartis reviewed the supplement for technical accuracy and compliance with relevant regulatory requirements before publication.

Prescribing information for Entresto® (sacubitril/valsartan) in adult patients for treatment of symptomatic chronic heart failure with reduced ejection fraction is available here.

Date of preparation: July 2019
Job bag number: ENT19-C029

Learning objectives

Advances in the treatment of chronic heart failure in real-world settings supplement programme

In this learning programme, based on a BJC supplement ‘Advances in the treatment of chronic heart failure with reduced ejection fraction in real-world settings’, we learn the role of sacubitril/valsartan in the treatment and management of chronic heart failure.

This supplement examined:
– the current evidence base for the use of the angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan
– the PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) study, the key randomised controlled trial that underpins the clinical use of sacubitril/valsartan
– key data from the PARADIGM-HF trial, which demonstrated significantly improved clinical outcome in patients with chronic heart failure with reduced ejection fraction (HFrEF), when compared with the angiotensin-converting enzyme (ACE) inhibitor, enalapril; and subgroup analyses of the study that support the use of sacubitril/valsartan in a broad range of patients with HFrEF
– initial experience of how this treatment has been initiated by heart failure teams at major centres around the UK

The publication discussed:
– how an evidence-based and pragmatic framework can be set up for initiating and successfully maintaining sacubitril/valsartan treatment for the care of people with HFrEF, in a manner consistent with current guidelines
– the real-world experience of initiating sacubitril/valsartan treatment for patients with HFrEF in Hampshire (Portsmouth Hospitals NHS Foundation Trust) and Warwickshire (University Hospital Coventry and Warwickshire)
– how two heart failure services in the community in Kent (Medway Community Healthcare) and Northern Ireland (Dungannon, Co. Down) embedded protocols and guideline-driven local guidance throughout the multi-disciplinary heart failure care team
– how to support patients to remain on sacubitril/valsartan treatment and the benefits brought to patients and healthcare practitioners
– how this approach can be extended to other key stakeholders, such as the hospital pharmacists

Accreditation

BJC Learning suggests that two hours of learning on this ‘Learning with reflection’ activity should be equivalent to 2 CPD/CME points

Instructions

This BJC Learning with reflection activity has a recommended award of two credits for the two hours of learning we estimate you will spend on this activity. You will need to read the following articles that comprise the activity:

Introduction
1. Applying PARADIGM-HF to the use of sacubitril/valsartan in clinical practice
2. Early clinical experience with sacubitril/valsartan from a large UK tertiary centre
3. Initial experience of introducing sacubitril/valsartan in a UK heart failure service
4. Sacubitril/valsartan prescribing and community experience in Medway
5. Real-world experience and clinical data with sacubitril/valsartan: a Northern Ireland perspective

After you have read these, you should reflect on what you have learnt and how it will influence your practice, and record this personal reflection in the box beneath the contributors. This will all be saved in the results section of your BJC Learning profile, which you can access at any time. This record can be printed off for revalidation purposes.

Contributors

Dr Pardeep S Jhund, Clinical Senior Lecturer,
Professor John J V McMurray, Professor of Medical Cardiology, British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow
Dr Danish Ali, Research Fellow, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Jacqui Hyland, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Fiona Riley, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Stephanie Kirkland, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Lisa Hinnit, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Catherine Watson, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Hayley Nicholson, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Johanna McCann, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Victoria Allport, Heart Failure Specialist Nurse, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Dr Fraz Umar, Locum Consultant Cardiologist, Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Professor Prithwish Banerjee, Consultant Cardiologist and Honorary Professor of Cardiology (Warwick Medical School and Coventry University), Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry
Ms Sarah Albarad, Medical Student, Warwick Medical School, Coventry
Mr Rajen Parekh, A Level Student, Bablake School, Coventry
Dr Richard J Crawley, Cardiology Specialist Registrar, Queen Alexandra Hospital, Portsmouth
Dr Geraint Morton, Consultant Cardiologist, Queen Alexandra Hospital, Portsmouth
Dr Navneet Kalsi, Cardiology Research Fellow, Queen Alexandra Hospital, Portsmouth
Dr Paul R Kalra, Consultant Cardiologist, Queen Alexandra Hospital, Portsmouth
Dr Kaushik Guha, Consultant Cardiologist, Queen Alexandra Hospital, Portsmouth
Ms Pauline Rouse, Cardiology Lead Nurse/Manager, Medway Community, Gillingham
Ms Edith Donnelly, BHF Heart Failure Nurse Specialist, Dungannon Area,
Ms Carol Patton, BHF Heart Failure Nurse Specialist, Dungannon Area

Use for revalidation – BJC Learning with reflection activity

This article can be used towards revalidation. If you would like to reflect on what you have learned, please log in or register to record your thoughts on how this article has influenced your practice.

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