2023 | HFSA

The Importance of Optimal Medical Therapy (OMT) and Collaborative Care

Practice News Provider Education

The HFSA Optimal Medical Therapy in Heart Failure (OMT-HF) program can help your patients achieve their best outcomes.

An estimated 6.5 million Americans have heart failure (HF). This year alone another 960,000 will likely be diagnosed with this condition. Chances are several of your patients are in this group. Are they receiving the optimal medical therapy (OMT), that helps them achieve their best outcomes? Is it guideline-directed medical therapy (GDMT)? What’s the difference? Are the optimal treatment choices different for patients who have HF with reduced ejection fraction (HFrEF) compared to patients who have HF with preserved ejection fraction (HFpEF)?

What is OMT?

OMT is a term used to describe optimal utilization of guideline-directed medical management and therapy for HF and it may be essential to successful patient outcomes. It is clear that poorly controlled HF is associated with negative consequences including decreased patient quality of life, frequent hospital readmissions, increased morbidity, mortality, and costs. The good news is, we now know a great deal more about HF and the importance of early intervention, treatment, and optimal use of guideline-recommended medical therapies. And you don’t have to be an HF specialist to help your patient achieve the best possible care.

The HFSA OMT-HF Certificate Program

The Heart Failure Society of America wants to help you and your patients achieve the optimal use of medical therapies for HF, to support their ability to lead a more normal, active life. The Optimal Medical Therapy in Heart Failure Certificate Program (OMT-HF) is an online program designed to provide the information you need to optimize treatment for your patients with HF. The program presents current data and recommendations for evidence-based, guideline-directed medical therapies for HF (GDMT), while also discussing the limitations and challenges in their application, and principles for up-titration to target or best-tolerated doses. Available Medical Therapy discussed includes ACE-Inhibitors (ACE-I) or Angiotensin Receptor Blockers (ARB), ARB + Neprilysin Inhibitor, Beta-Blockers, Mineralocorticoid Antagonists, Nitrates, Cardiac Glycosides, and Diuretics.

This program goes beyond just providing clinical trial data and the guidelines. OMT-HF also presents proven clinical strategies on how to manage medical therapy for heart failure and achieve the targeted therapeutic doses. Utilizing focused education, OMT-HF provides guidelines and evidence-based educational information on therapeutic approaches, monitoring patients, and recognizing the signs and symptoms that may be signaling a need to adjust or change the treatment. The program reviews drugs and supplements that may worsen the prognosis of HF patients and discusses some potential drug-drug interactions and their potential consequences.

The Importance of Collaborative Care and Shared Decision-Making

Non-heart failure specialist providers commonly prescribe and routinely manage HF medications. These practitioners may include general cardiologists, hospitalists, internists, family practice physicians, nurse practitioners, and physician assistants. Non-prescribing healthcare professionals such as clinical pharmacists, nurses, or case managers also play a critical role in the medical management of HF patients. Numerous studies have shown that optimizing medical therapy for HF requires a multidisciplinary approach. Building a cohesive multidisciplinary team that monitors the patient and their medication regimens to ensure appropriateness, compliance, dosing, duplications, omissions, and drug interactions is critical. 

The patient is the other key component in providing effective collaborative care. Patients interact daily with a variety of practitioners that have both prescriptive and non-prescriptive privileges. Incorporating patient/provider-shared decision-making has been shown to improve outcomes. Enhanced patient engagement in selecting interventions based on individual values, preferences, and associated conditions and comorbidities improves medication compliance, patient quality of life, and medical outcomes. The OMT-HF program discusses the best practices for collaborative care between the multidisciplinary team and the patient. The program presents proven approaches that can reduce all-cause and HF-related hospitalizations and mortality while improving overall patient health and satisfaction through better management across the continuum of care. 

Why You and Your Team Should Complete the OMT-HF Certificate Program

OMT-HF is an assessment-based certificate program that recognizes the critical role that non-heart failure specialists play in providing optimal medical therapy for patients with HF. This online, 3-module program that offers 3.0 credits of CME, CNE (NCPD) and CPE can help advance your knowledge and apply practical aspects of OMT. From treatment selection, initiation, and titration to proper target doses, this program covers evidence-based therapies for HF, dosing, prescription optimization, and collaborative management techniques. Furthermore, the OMT-HF certificate program aligns with the new 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure, to help your patients achieve better patient outcomes.

The goal of HF therapy is to relieve symptoms such as shortness of breath, decreased exercise tolerance, and lower-extremity edema, and improve the patient’s functional capacity and quality of life, while slowing disease progression, and decreasing hospital readmissions, morbidity, mortality, and costs. Studies have shown that several classes of medication improve outcomes in HF, however many patients do not receive these medications, or receive them at lower than optimal doses. Guidelines and clinical trials can identify the drug options, dose, and target dose to be achieved. But, guideline-recommended management of HF is only effective when providers and patients work together to optimize their care. The OMT-HF certificate program is intended for general cardiologists, internists, advanced practice providers, and pharmacists who commonly care for patients with heart failure (HF), but who do not specialize in this area.