Pharmacist intervention in the prevention of heart failure for high-risk elderly patients in the community

BACKGROUND: Heart failure has become one of the major causes of hospitalization worldwide. Hypertension, diabetes mellitus and hyperlipidemia are the major causes of heart failure. In order to effectively prevent heart failure, blood pressure, blood glucose and cholesterol levels shall be closely monitored and controlled as well as medication adherence. This study aimed to investigate the role of pharmacist intervention in prevention of heart failure in high risk elderly patients in the community of Hong Kong. AIM: This study aimed to investigate the role of pharmacist intervention in prevention of heart failure in highrisk elderly patients in the community of Hong Kong. METHODS: This prospective uncontrolled study was conducted between July 2012 and April 2013 with two revisits every 3 to 4 months to review elderly patients' medication profiles as well as assess their blood pressure (BP), random capillary blood glucose (RCBG) level, cholesterol levels, signs and symptoms of heart failure and the compliance level. The results collected at the baseline data were analyzed and compared with those collected at the last follow-up visit. RESULT: A significant increase in number of subjects free of symptoms of heart failure (31.88%, p < 0.001) was found. For chronic disease management, significant reduction in LDL-cholesterol level (-0.86 ± 0.56mmol/L, p = 0.038) and triglyceride level (-1.15 ± 1.09mmol/L, p < 0.001) was observed in overall participants. Yet, no significant reduction in BP level or RCBG level was observed in overall subjects. Significant reduction in mean Morisky Medication Adherence Score (-0.54 ± 1.50, p = 0.005) indicated improvement in medication compliance in participants. CONCLUSION: The Pharmacy Outreach service has a significant role in prevention of heart failure, by means of minimizing heart failure symptoms, improving medication compliance and enhancing chronic disease management, particularly cholesterol management in community elderly patients. This study provided a reference for further investigation and evaluation of the role of pharmacists in preventing heart failure in the high-risk community elderly patients.