129 Improving the assessment of iron status and replacement among heart failure patients

Introduction Recent evidence has shown that iron deficiency is a significant co-morbidity in heart failure patients independent of their anaemia status. Iron deficiency is present in about 55% of chronic and 80% of acute heart failure patients and has been associated with reduced exercise capacity, recurrent heart failure hospitalisations, and high cardiovascular and all-cause mortality. A quality improvement project was therefore designed to improve the diagnosis and treatment of iron deficiency in heart failure patients in our tertiary care centre. Methods An initial baseline dataset was collected, followed by two cycles examining a cross section of heart failure patients admitted to our hospital over a two-month period. The Plan-Do-Study-Act (PDSA) cycle approach was applied, with the first intervention involving raising awareness of the importance and need to assess iron status of heart failure patients through education provided to doctors, nurses, and patients. Furthermore, informational leaflets were produced and disseminated across the medical wards through social media forums such as WhatsApp™. The post-intervention datasets were collected and compared to the baseline outcomes. Results Baseline data collected over a month period showed that 20% (4) of the heart failure patients had their iron status checked and 75% (3) of them were iron depleted (see table 1). Following the first intervention, the compliance improved from 20% to 55% (11). It was observed that nine of the eleven patients assessed for iron status had iron deficiency while appropriate iron replacement was done for 5 (55%) of them. This increased further following PDSA cycle 2 as 80% of patients were assessed for iron status and 85% of those identified to have iron deficiency had iron replacement intravenously using ferric carboxymaltose. Conclusion We have shown that simple intervention through a QIP can improve the assessment of iron deficiency in patients with heart failure, enable timely replacement and therefore lead to better outcome for these patients. Conflict of Interest None