Impact of Clinical Pharmacy Fellows in Training Interventions on Drug Optimization and Patient Education among Patients with Cardiovascular Disease

Aim . To evaluate clinical pharmacy fellows in training (FITs) in relation to medication optimization, physician acceptance of recommendations, patient education, and recorded medication adherence among hospitalized patients with cardiovascular disease. Material and methods . A prospective, nonrandomized comparative observational study was conducted at Baghdad Teaching Hospital, Iraq, from January to November 2021. Group A comprised 150 patients with documented ward-based FIT interventions; group B comprised 153 patients assessed when ward-based FITs were absent. A researcher who was a FIT evaluated intervention needs in group B and discussed them with treating physicians. Interventions were categorized as initiation, dose modification, monitoring, switching, cessation, or education. Categorical comparisons were recalculated from aggregate counts using the confirmed group sizes. Results . Among 303 patients, 318 interventions were documented in group A, and 222 intervention needs were identified for 102 patients in group B.In the cardiac care unit, cardiologists accepted 151 of 167 recommendations (90.4%). Recorded medication adherence was 134/150 (89.3%) in group A and 87/153 (56.9%) in group B (p<0.001). The unadjusted absolute difference was 32.5 percentage points. Knowledge of new medications and their indications was also more frequent in group A.Ward-level and intervention-category totals were inconsistent and were analyzed separately. Conclusion . Ward-based FIT participation was associated with higher recorded medication adherence and greater patient knowledge. The findings support further evaluation of supervised clinical pharmacy training, but nonrandom allocation, differences in ward staffing and case mix, and incomplete outcome documentation preclude causal conclusions.