What question did this study set out to answer?

To evaluate whether implementing a pharmacist-managed amiodarone clinic and protocol improves adherence to guideline monitoring parameters and adverse effect detection.

January 1, 2004Journal of Pharmacy Technology

Effectiveness of an Amiodarone Protocol and Management Clinic in Improving Adherence to Amiodarone Monitoring Guidelines

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Why the study?

Does a pharmacist-managed Amiodarone Management Clinic improve adherence to monitoring guidelines in patients receiving amiodarone?

Population

225 patients with an active amiodarone prescription

Comparison

Enrollment in a pharmacist-managed Amiodarone… vs Standard medical care by nonpharmacist…

Design

Cohort

Authors

MGMaqual R. GrahamUniversity of Missouri–Kansas City MWMarcia WrightPfizer (United States)HMHarold J. ManleyUniversity of Minnesota

Discussion

Member takes

Implication

Pharmacist-managed amiodarone clinics were associated with improved monitoring compliance; hypothesis-generating and requires prospective trials before practice change.

Key Points

To evaluate whether implementing a pharmacist-managed amiodarone clinic and protocol improves adherence to guideline monitoring parameters and adverse effect detection.
Retrospective chart review of 225 patients with an active amiodarone prescription.
Patients were compared between those enrolled in the pharmacist-managed Amiodarone Management Clinic (intervention, n=154) and those receiving standard care from nonpharmacist practitioners (control, n=71).
Thyroid function monitoring compliance was significantly higher in the intervention group than the control group (66% [101/154] vs 37% [26/71], p < 0.0001).
Liver function monitoring compliance was significantly greater in the intervention group compared to controls (69% [106/154] vs 38% [27/71], p < 0.0001).
Documented adverse effects were significantly higher in the intervention group (68 of 154) compared to the control group (8 of 71, p < 0.0001).

Structured PICO

Does a pharmacist-managed Amiodarone Management Clinic improve adherence to monitoring guidelines in patients receiving amiodarone?

Population

225 patients with an active amiodarone prescription

Intervention

Enrollment in a pharmacist-managed Amiodarone Management Clinic (AMC) and protocol

Comparator

Standard medical care by nonpharmacist practitioners

Outcome

Compliance with recommended monitoring parameters, including the presence of interacting medications and associated drug concentration or international normalized ratio (INR)

A pharmacist-managed amiodarone clinic significantly improves adherence to guideline-recommended safety monitoring compared to standard care.

Limitations

Unclear whether the higher rate of documented adverse effects in the intervention group reflects an improved event detection rate or actual higher incidence

Cite This Study

Graham et al. (2004) studied this question.

synapsesocial.com/papers/6a79704314b028facf0dc5d5 https://doi.org/10.1177/875512250402000103

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Implication

Pharmacist-managed amiodarone clinics were associated with improved monitoring compliance; hypothesis-generating and requires prospective trials before practice change.

Effectiveness of an Amiodarone Protocol and Management Clinic in Improving Adherence to Amiodarone Monitoring Guidelines

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Effectiveness of an Amiodarone Protocol and Management Clinic in Improving Adherence to Amiodarone Monitoring Guidelines

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider