2% (5/33), all of which were for HF exacerbation. The 30-day all-cause readmission rate for the hospital in 2010 was 28.3% (143/505). Sensitivity analyses with respect to missing data at the 5-month study visit revealed that the results presented in table 2 were fairly robust, given the size of the sample. Almost all changes from baseline in sellekchem physician adherence continued to be non-statistically significant for all three medication classes under all three sensitivity analysis scenarios. The exception was observed under the ‘Worst Case’ scenario, in which an even deeper decrease in adherence with respect to β-blockers

was observed that achieved statistical significance (p<0.01). Sensitivity analyses with respect to patient-drug adherence and sodium intake data produced results similar to those presented in table 2, with the exception of an even greater

decrease (that was statistically significant, p<0.01) in patient adherence as measured by pill cap at 5 months under the ‘Worst Case’ scenario and a statistically significant (p=0.03) increase in adherence as measured by the Morisky score under the ‘Best Case’ scenario. Discussion The primary purpose of this pilot study was to assess the feasibility of a novel intervention and gain important insights into issues that may need to be addressed in a larger trial.17 From that perspective, our pilot study had encouraging results. We were able to deliver the intervention to both physicians and patients. All physicians received appropriate patient-specific feedback in a timely manner and more than 80% of patients completed at least 80% of their intervention visits. We were able to acquire data on hospitalisations and deaths.

These findings suggest that the intervention is amenable to implementation in a larger trial. While a pilot study is not designed to provide definitive insights as to the impact of an intervention, we observed a significant decline in sodium intake and a trend towards a lower rate of HF hospitalisations in study patients compared with the general hospital census. One of the exploratory aims of our study was to assess changes in sodium intake, as sodium restriction in patients with HF was an area of potential intervention based on the prevailing literature Carfilzomib at the time.18 19 In fact, sodium restriction in patients with HF was a class I recommendation based on the 2005 and 2009 ACC/AHA guidelines.10 11 This has been challenged recently by studies showing adverse outcomes in patients with HF with low daily sodium intake.20–22 Current ACC/AHA guidelines for HF still recommend sodium restriction, though as a Class IIa recommendation.3 Our pill cap data indicated a trend towards decreased patient adherence postintervention while data from MMAS indicated otherwise. Although pill cap monitoring is an objective adherence measure, it relies on appropriate use by the patient.