Pharmacist Care of Patients With Heart Failure<subtitle>A Systematic Review of Randomized Trials</subtitle>

Abstract

Background: While the role of multidisciplinary teams in the treatment of patients with heart failure (HF) is well established, there is less evidence to characterize the role of individual team members. To clarify the role of pharmacists in the care of patients with HF, we performed a systematic review evaluating the effect of pharmacist care on patient outcomes in HF.

The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients

“…16 Pharmacist involvement in the management of these patients has been shown to reduce HF hospitalizations, with trends towards a reduction in mortality. 17 Literature is scarce on instruments that clinicians can use to identify patients at risk for medication nonadherence. The objective of this review was to (a) describe factors that predict medication adherence for patients with HF, (b) evaluate the impact and value of pharmacist interventions on adherence and outcomes, and (c) assess tools to predict medication nonadherence in HF patients.…”

“…17 Interestingly, interventions where the pharmacist participated as part of a multidisciplinary team (collaborative care) led to greater reductions in HF hospitalizations when compared with pharmacist-directed care (OR = 0.42, 95% CI = 0.24-0.74, P = 0.002 vs. OR = 0.89, 95% CI = 0.68-1.17, P = 0.41, respectively).…”

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

“…However, the published overview analyses have been able to provide some direction with regard to the most effective type of DMP. Multidisciplinary programs involving both a doctor and a nurse specializing in HF management appear to be a consistent requirement for these programs, with the potential for further benefit from the addition of other allied health professionals such as a pharmacist (122,123,126,127,138). Combinations of in-clinic and telephone follow-ups would appear to be important with entry into the DMP as soon as possible after discharge (122,124,125).…”

Physical Assessment Experience in a Problem-Based Learning Course

“…1,2 Specifically, chronic obstructive pulmonary disease (COPD), heart failure, and hypertension are disease states for which pharmacist intervention has clearly demonstrated significant improvement in patient outcomes. [3][4][5][6][7] For these disease states, assessment is key to the proper selection and management of medications. Patient assessment is an organized and systematic approach to medication and disease state management that uses distinct techniques.…”