Streamlining Post-PCI Medication Access to Improve DAPT Adherence and Outcomes

Dual antiplatelet therapy after percutaneous coronary intervention (PCI) is essential to prevent stent thrombosis and improve outcomes. Barriers such as cost, insurance delays, limited patient understanding, and pharmacy availability can hinder timely initiation and adherence. Delays are common when community pharmacies do not stock certain P2Y12 inhibitors, particularly newer, higher cost agents such as ticagrelor.

We sought to reduce these barriers by integrating hospital outpatient pharmacy services into post-PCI discharge planning for both inpatient and outpatient PCI.

A multidisciplinary team routed P2Y12 inhibitor prescriptions to the hospital's outpatient pharmacy, enabling financial assistance, streamlined prior authorizations, and bedside delivery before discharge. In a 2-week preimplementation audit, 5 of 9 ticagrelor, 3 of 3 clopidogrel, and 9 of 10 prasugrel prescriptions sent externally were filled. At postimplementation, 99.1% of prescriptions were filled and delivered bedside.

Leveraging hospital pharmacy resources for outpatient PCI patients ensures timely access to dual antiplatelet therapy, improves adherence, and reduces adverse cardiovascular events.