Role of Clinical Pharmacists in Heart Failure Management: ImprovingTherapeutic Outcomes and Patient Care

Abstract

Heart failure (HF) is a progressive cardiovascular syndrome associated with substantial morbidity, mortality, recurrent hospitalization, polypharmacy, and healthcare utilization. Contemporary HF therapy has become increasingly complex with the widespread use of guideline-directed medical therapy (GDMT), including angiotensin receptor–neprilysin inhibitors, evidence-based beta blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. Although these therapies improve outcomes, implementation in routine practice is frequently limited by suboptimal prescribing, inadequate titration, adverse drug reactions, medication discrepancies, and poor adherence. Clinical pharmacists can address these medication-related challenges through structured medication therapy management, reconciliation, patient education, adherence support, therapeutic monitoring, pharmacovigilance, and participation in multidisciplinary care. Pharmacist-led interventions have been associated with improvements in medication safety, adherence, GDMT optimization, readmission outcomes, and patient-reported quality of life, although the magnitude of benefit varies according to intervention design and healthcare setting. Emerging approaches such as telepharmacy, digital clinical decision support, artificial intelligence, and pharmacogenomics may further extend pharmacist involvement. This review discusses the current role of clinical pharmacists in HF management, evidence for clinical and patient-centred outcomes, barriers to implementation, and potential future directions