Key result
Discharge education by clinical pharmacists significantly improved adherence to aspirin (59% vs 47%; aOR 1.5; 95% CI 1.1-1.9; P=0.002) and other post-PCI medications compared to other providers.
Why the study?
Adherence to secondary prevention medications post-myocardial infarction is essential, but the impact of education by clinical pharmacists following primary PCI has not been evaluated in a real-world context.
Does discharge education by clinical pharmacists improve adherence to post-PCI medications in patients with STEMI?
Cohort (n=1,334)
No
Does discharge education by clinical pharmacists improve adherence to post-PCI medications in patients with STEMI?
Odds Ratio: 1.5 (95% CI 1.1–1.9)
Absolute Event Rate: 59% vs 47%
p-value: p=.002
Discharge education provided by clinical pharmacists significantly improves adherence to secondary prevention medications in patients post-STEMI compared to education by other healthcare providers.
Pharmacist-led education was associated with higher post-STEMI adherence; hypothesis-generating and requires RCTs before practice change.
Background Secondary prevention post myocardial infarction by optimizing secondary prevention cardiovascular medications is important; however, adherence to these medications is essential to achieve benefits. Nevertheless, the impact of education provided by clinical pharmacists to patients post primary percutaneous coronary intervention (PCI) has not yet been evaluated in a real‐world context. Methods This retrospective observational cohort study aimed to assess the impact of education provided by clinical pharmacists compared with other health care providers on adherence to post‐PCI medications and clinical outcomes among patients with ST‐elevation myocardial infarction (STEMI). This study included all patients admitted with STEMI to Heart Hospital in Qatar between 1 January 2016 and 31 December 2018. Adherence was assessed by medication availability 80% of the time, which was monitored by the rate of prescription refill in the year after discharge. Results A total of 1334 patients were included. The majority of patients included were male (96%) and Asian (78%), with a mean age of 51 years. Only 26% of the study population were educated by clinical pharmacists, while the remaining were educated by other health care professionals upon discharge. Adherence to aspirin, P2Y12 inhibitors, statins, and beta‐blockers was significantly better among patients who were educated by clinical pharmacists (aspirin, 59% vs 47%; adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1‐1.9; P = .002; P2Y12 inhibitor, 58% vs 47%; aOR, 1.5; 95% CI, 1.1‐1.9; P = .004; statin, 55% vs 46%; aOR, 1.3; 95% CI, 1.0‐1.7; P = .038; beta‐blocker, 46% vs 37%; aOR, 1.4; 95% CI, 1.1‐1.8; P = .018). However, there was no difference in re‐hospitalization for acute coronary syndrome or all‐cause mortality among patients who were educated by clinical pharmacists upon discharge compared with those who were educated by other health care providers. Conclusion Medication counseling provided by clinical pharmacists significantly improved adherence to post‐PCI medications among patients with STEMI.
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Rahhal et al. (2020) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=1,334). Discharge education by clinical pharmacists vs. Education by other health care professionals was evaluated on Adherence to aspirin (medication availability 80% of the time in the year after discharge) (aOR 1.5, 95% CI 1.1-1.9, p=.002). Discharge education by clinical pharmacists significantly improved adherence to aspirin (59% vs 47%; aOR 1.5; 95% CI 1.1-1.9; P=0.002) and other post-PCI medications compared to other providers.
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