The involvement of pharmacists in cardiac rehabilitation: a review of the literature

Objective To identify, review and evaluate the literature regarding the role of the pharmacist in cardiac rehabilitation (CR). Method Electronic databases searched up to October 2004 were Medline, Pharmline, Iowa Drug Information service, International Pharmacy Abstracts, Embase, Scanners and Web of Science. Reference lists of identified papers were searched and a Zetoc email alert was created to identify additional papers. Papers were included only if they referred specifically to a CR programme or CR patients, and also referred to the involvement of pharmacists or concerned pharmacy practice research. Reports were not excluded on the basis of quality, however reports that met the criteria for inclusion were allocated an evidence grade to indicate quality. Key findings Thirteen reports were identified, of which six reports were purely descriptive accounts of pharmacists' involvement in CR (all were from the US) and seven were evaluative reports (four from the US, two from the UK and one from Canada). Descriptions of the involvement of pharmacists in CR included providing medicines information and education to patients, and optimising drug therapy. The lack of substantial research was notable among the evaluative reports. One study found quality of life and economic benefits as a result of the involvement of a pharmacist in CR, and another found that health professionals provide most of the medicines information and education required by CR patients. However these studies were weakened by a lack of meaningful outcome measures. Conclusion There is insufficient evidence on which to base firm conclusions about the effectiveness of the involvement of pharmacists in CR. This has implications for pharmacy practitioners, researchers and policymakers in CR.