Assessment of Drug Therapy-Related Issues in an Outpatient Heart Failure Population and the Potential Impact of Pharmacist-Driven Intervention

Dempsey, Jillian; Matta, Lina; Carter, Danielle M.; Stevens, Craig; Stevenson, Lynne Warner; Desai, Akshay S.; Cheng, Judy

doi:10.1177/0897190016641491

Cited by 18 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition to guideline‐recommended medications, patients with CHF receive often pharmacotherapy for frequent co‐morbidities leading to polypharmacy . Especially elderly patients with polypharmacy are at risk to experience DRPs like double medication, drug interactions, adverse drug reactions, or non‐adherence . Adverse drug events and therapy failure due to DRPs are potentially preventable by interdisciplinary efforts involving pharmacists.…”

Section: Introductionmentioning

confidence: 99%

PHARMacy‐based interdisciplinary program for patients with Chronic Heart Failure (PHARM‐CHF): rationale and design of a randomized controlled trial, and results of the pilot study

Laufs

Griese‐Mammen

Krueger

et al. 2018

European J of Heart Fail

View full text Add to dashboard Cite

We report the rationale and design of a community PHARMacy-based prospective randomized controlled interdisciplinary study for ambulatory patients with Chronic Heart Failure (PHARM-CHF) and results of its pilot study. The pilot study randomized 50 patients to a pharmacy-based intervention or usual care for 12 months. It demonstrated the feasibility of the design and showed reduced systolic blood pressure in the intervention group as indicator for improved medication adherence. The main study will randomize patients ≥60 years on stable pharmacotherapy including at least one diuretic and a history of heart failure hospitalization within 12 months. The intervention group will receive a medication review at baseline followed by regular dose dispensing of the medication, counselling regarding medication use and symptoms of heart failure. The control patients are unknown to the pharmacy and receive usual care. The primary efficacy endpoint is medication adherence, pre-specified as a significant difference of the proportion of days covered between the intervention and control group within 365 days following randomization using pharmacy claims data for three CHF medications (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, and mineralocorticoid receptor antagonists). The primary composite safety endpoint is days lost due to blindly adjudicated unplanned cardiovascular hospitalizations or death. Overall, 248 patients shall be randomized. The minimum follow-up is 12 months with an expected mean of 24 months. Based on the feasibility demonstrated in the pilot study, the randomized PHARM-CHF trial will test whether an interdisciplinary pharmacy-based intervention can safely improve medication adherence and will estimate the potential impact on clinical endpoints. ClinicalTrials.gov Identifier: NCT01692119.

show abstract

Section: Introductionmentioning

confidence: 99%

PHARMacy‐based interdisciplinary program for patients with Chronic Heart Failure (PHARM‐CHF): rationale and design of a randomized controlled trial, and results of the pilot study

Laufs

Griese‐Mammen

Krueger

et al. 2018

European J of Heart Fail

View full text Add to dashboard Cite

show abstract

“…Pharmacist intervention by delivering pharmaceutical care in a multidisciplinary care team has been shown to improve clinical outcomes in a variety of patients with chronic diseases such as heart failure, hypertension, and diabetes. 9 – 11 As concerns psychiatric disorders, some clinical studies have addressed pharmaceutical care in psychiatric patients with depression and autism spectrum disorder. 12 , 13 The results also revealed that pharmacist intervention could help to improve clinical outcomes in these patients.…”

Section: Introductionmentioning

confidence: 99%

Anticholinergic discontinuation and cognitive functions in patients with schizophrenia: a pharmacist–physician collaboration in the outpatient department

Sathienluckana¹,

Unaharassamee²,

Suthisisang³

et al. 2018

IPRP

View full text Add to dashboard Cite

IntroductionCognitive impairment is a core feature and shows the highest impact on functional outcome in patients with schizophrenia. There have been no previous studies investigating the role of the pharmacist in a multidisciplinary team on cognitive outcomes in patients with schizophrenia.PurposeWe evaluated the impact of pharmacist intervention on cognitive outcomes in patients with schizophrenia by focusing on anticholinergic discontinuation.Patients and methodsA prospective, open-label, randomized, controlled study was conducted. Patients with schizophrenia were randomly assigned to either the pharmacist intervention or usual care groups. In the pharmacist intervention group, the pharmacist identified drug-related problems (DRPs) and provided a pharmacotherapy suggestion, while there was no intervention in the usual care group. The primary outcome was mean change from baseline of executive function by using Wisconsin Card Sorting Test (WCST) perseverative errors within the pharmacist intervention group at week 12.ResultsA total of 30 patients completed the study (13 in the pharmacist intervention group and 17 in the usual care group). WCST perseverative errors at the end of the study within the pharmacist intervention group improved significantly from baseline (P=0.003). DRPs at week 12 were reduced by 85.19% and 9.76% in the pharmacist intervention and usual care groups, respectively. The most common intervention was the discontinuation of anticholinergics in patients without extrapyramidal side effects.ConclusionAdded-on pharmacist intervention in a multidisciplinary team could help to improve cognitive functions in patients with schizophrenia by reducing DRPs and optimizing the drug therapy regimen, especially for anticholinergic discontinuation.

show abstract

“…Pharmacist interventions on outpatient prescriptions were rarely reported. Limited studies were restricted to certain type of outpatient prescriptions, such as prescriptions of pediatric patients [ 8 ], geriatric patients [ 9 ], emergency patients [ 10 ], patients undergoing oral chemotherapy [ 11 , 12 ] and those with heart failure [ 13 ]. These limited articles have all demonstrated that pharmacist intervention can reduce suboptimal prescriptions.…”

Section: Introductionmentioning

confidence: 99%

Clinical and economic impact of pharmacist interventions on sampled outpatient prescriptions in a Chinese teaching hospital

Bao¹,

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundLimited studies have evaluated the effectiveness of pharmacist interventions on outpatient prescription. The goal of this study was to evaluate the clinical and economic impacts of pharmacist interventions on randomly sampled outpatient prescriptions.MethodOutpatient prescriptions of our hospital were sampled automatically and reviewed by pharmacists since 2011. Pharmacists intervened in inappropriate prescriptions (IPs) real-timely, and summarized and analyzed the information monthly. Cost-benefit analysis was performed to estimate the economic benefit of the pharmacist intervention.ResultsFrom 2011 to 2016, pharmacists reviewed 101,271 prescriptions and intervened in 5155 prescriptions. With the interventions of pharmacists, the number of IPs decreased from 1845 to 238, while the inappropriate percentage decreased from 12.60 to 1.22%. The inappropriate rates of different departments and the types decreased annually. IPs were mainly from the Department of Medicine and Department of Surgery and category 1 (Non-indicated medications) in all years. The benefit-to-cost ratios of pharmacist interventions were always more than 1. In the same years, the benefit-to-cost ratios in public payments were higher than those with insurance and self-payment.ConclusionThis form of pharmacist intervention constitutes a method that showed positive clinical and economic benefits and is worth expanding in large hospitals. Pharmacists should pay more attention on prescriptions in department of surgery or prescriptions with public payments.

show abstract

Assessment of Drug Therapy-Related Issues in an Outpatient Heart Failure Population and the Potential Impact of Pharmacist-Driven Intervention

Abstract: The prevalence of DRI is high even among HF patients managed in a subspecialty cardiovascular practice. Pharmacists in this setting play a vital role in more effectively resolving DRI.

Cited by 18 publications

References 15 publications

PHARMacy‐based interdisciplinary program for patients with Chronic Heart Failure (PHARM‐CHF): rationale and design of a randomized controlled trial, and results of the pilot study

PHARMacy‐based interdisciplinary program for patients with Chronic Heart Failure (PHARM‐CHF): rationale and design of a randomized controlled trial, and results of the pilot study

Anticholinergic discontinuation and cognitive functions in patients with schizophrenia: a pharmacist–physician collaboration in the outpatient department

Clinical and economic impact of pharmacist interventions on sampled outpatient prescriptions in a Chinese teaching hospital

Contact Info

Product

Resources

About

Assessment of Drug Therapy-Related Issues in an Outpatient Heart Failure Population and the Potential Impact of Pharmacist-Driven Intervention

Abstract: The prevalence of DRI is high even among HF patients managed in a subspecialty cardiovascular practice. Pharmacists in this setting play a vital role in more effectively resolving DRI.

Cited by 18 publications

References 15 publications

PHARMacy‐based interdisciplinary program for patients with Chronic Heart Failure (PHARM‐CHF): rationale and design of a randomized controlled trial, and results of the pilot study

PHARMacy‐based interdisciplinary program for patients with Chronic Heart Failure (PHARM‐CHF): rationale and design of a randomized controlled trial, and results of the pilot study

Anticholinergic discontinuation and cognitive functions in patients with schizophrenia: a pharmacist&ndash;physician collaboration in the outpatient department

Clinical and economic impact of pharmacist interventions on sampled outpatient prescriptions in a Chinese teaching hospital

Contact Info

Product

Resources

About

Anticholinergic discontinuation and cognitive functions in patients with schizophrenia: a pharmacist–physician collaboration in the outpatient department