Effectiveness of pharmacist’s intervention in the management of cardiovascular diseases

Abstract

The pharmacist may play a relevant role in primary and secondary prevention of cardiovascular diseases, mainly through patient education and counselling, drug safety management, medication review, monitoring and reconciliation, detection and control of specific cardiovascular risk factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes. Systematic reviews of randomised controlled and observational studies have documented an improved control of hypertension, dyslipidaemia or diabetes, smoking cessation and reduced hospitalisation in patients with heart failure, following a pharmacist’s intervention. Limited proof for effectiveness is available for humanistic (patient satisfaction, adherence and knowledge) and economic outcomes. A multidisciplinary approach, including medical input plus a pharmacist, specialist nurse or both, and a greater involvement of community rather than hospital pharmacists, seems to represent the most efficient and modern healthcare delivery model. However, further well-designed research is demanded in order to quantitatively and qualitatively evaluate the impact of pharmacist’s interventions on cardiovascular disease and to identify specific areas of impact of collaborative practice. Such research should particularly focus on the demonstration of a sensitivity to community pharmacist’s intervention. Since pharmacy services are easily accessible and widely distributed in the community setting, a maximum benefit should be expected from interventions provided in this context.

Impact of the pharmacist‐led intervention on the control of medical cardiovascular risk factors for the primary prevention of cardiovascular disease in general practice: A systematic review and meta‐analysis of randomised controlled trials

“…However, over the past few years, GP has faced increased workload due to multiple reasons including the increase in population and average lifespan, increased prevalence of long‐term medical conditions, frequency of diseases and complexity of treatment regimen . Pharmacists by virtue of patient education, medicine reconciliation and management of CVD risk factors can play an important role in the primary prevention of CVD that can help ease the burden on primary care physicians (PCP).…”

Pharmacists get to the heart of the matter

“…An overview of this body of research has been summarized by Omboni and Caserini. 1 The authors have concluded that "A common finding of the systematic reviews is that greater involvement of pharmacists in activities directed to the patients and collaboration with other health care professionals in a team may provide an enhanced effect on various outcomes and may ultimately positively affect public health." Furthermore, a systematic review by Santschi et al 2 evaluated 39 controlled trials of pharmacists' care for patients with CVD in ambulatory settings.…”

“…Pharmacists who directly engage patients to provide guidance on medication use, along with follow-up to monitor patients' progress, can support high levels of adherence to medications, whereas physicianpharmacist collaboration can lead to better prescribing and monitoring of patients. 1,3,4 Cardiometabolic disease begins with insulin resistance, progressing to metabolic syndrome, prediabetes, and ultimately to cardiovascular disease and type 2 diabetes. 5 Cardiometabolic complications have been increasing owing to the increasing prevalence of contributing disease states (e.g., hypertension, diabetes, and obesity).…”

“…As there is a strong association between diabetes and cardiovascular health, it is imperative that health care providers work to reduce cardiometabolic risk factors through early assessment and subsequent targeted interventions. 1 In 2015, the Cardiovascular Team and Prevention of Cardiovascular Disease Council of the American College of Cardiology released a paper describing the role of clinical pharmacists and their training, certification, and potential utilization in cardiovascular care practice models. 6 Pharmacists can play a key role in cardiometabolic health-risk reduction as part of an interprofessional team through diet, lifestyle, and disease-state education; risk assessment; optimization of the pharmacologic treatment of disease; avoidance of adverse effects;…”

Pharmacists get to the heart of the matter

“…Pharmacist interventions have been shown to consistently benefit the management of hypertension, hyperlipidemia, diabetes, and smoking cessation. 10 Patients who have a pharmacist involved in their blood pressure management show statistically significant improvements in their medication adherence, disease-state knowledge, and blood pressure control. 11 Hunt et al 12 found that pharmacist intervention improved the percentage of patients whose blood pressure was controlled from 44% to 62%.…”