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A pharmacist-led follow-up program for patients with established coronary heart disease in North Norway - a

Beate H Garcia1, Trude Giverhaug2, June U Høgli3

  • 1Hospital Pharmacy of North Norway; & Department of Pharmacy, University of Tromsø . Tromsø ( Norway ). beate.garcia@uit.no.

Pharmacy Practice
|July 2, 2015
PubMed

Insights

A clinical pharmacist-led follow-up program improved adherence to secondary prevention guidelines for coronary heart disease (CHD) patients. While biomedical risk factors did not significantly change, the program highlights the pharmacist

Area of Science:

  • Cardiology
  • Clinical Pharmacy
  • Public Health

Background:

  • Coronary heart disease (CHD) requires ongoing management and adherence to secondary prevention strategies.
  • Clinical pharmacist interventions can play a role in improving patient outcomes and guideline adherence.
  • A structured follow-up program may enhance the effectiveness of secondary prevention in CHD patients.

Purpose of the Study:

  • To develop and evaluate a 12-month clinical pharmacist-led follow-up program for post-discharge CHD patients.
  • To assess the program's impact on adherence to the medication assessment tool for secondary prevention of CHD (MAT-CHDSP).
  • To explore changes in biomedical risk factors (cholesterol, blood pressure, blood glucose) following the intervention.

Main Methods:

  • A non-blinded randomized controlled trial involving 102 patients with established CHD.
  • Intervention group received pharmacist-led medication reconciliation, review, and education at discharge, 3, and 12 months.
  • Control group received standard care; primary outcomes were adherence to MAT-CHDSP criteria, secondary outcomes were changes in risk factors.

Main Results:

  • Overall adherence to MAT-CHDSP criteria increased in both groups, significantly higher in the intervention group (78.4% vs. 62.0%, p<0.001).
  • Statistically significant improvements were observed for documented lifestyle advice in the intervention group.
  • No significant improvements in biomedical risk factors (cholesterol, blood pressure, blood glucose) were found in favor of the intervention group.

Conclusions:

  • Attention to clinical practice guideline recommendations, potentially a clinical pharmacist task, enhances adherence.
  • A larger, adequately powered study is required to demonstrate significant differences in biomedical risk factor improvements.
  • Program amendments are suggested before widespread implementation in standard patient care for CHD secondary prevention.
Abstract

Keywords:
Coronary DiseaseMedication ReconciliationNorwayPharmaceutical ServicesPharmacistsRandomized Controlled Trials as Topic

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