Clinical pharmacist interventions in secondary prevention of cardiovascular disease improved patient outcomes compared with control in 68% of the reported outcomes across 59 identified studies.
Systematic Review (n=59)
Does clinical pharmacist intervention improve outcomes in patients with CVD or CVD risk factors?
Clinical pharmacist interventions in secondary prevention of CVD improve patient outcomes, risk factor control, and medication management.
BACKGROUND: Cardiovascular disease (CVD) is considered to be the main cause of death and one of the most common diseases affecting health care systems worldwide. Many methods have been used to improve CVD outcomes, one of which is to involve clinical pharmacists in the direct care of patients with CVD. OBJECTIVE: To perform a systematic review assessing the effectiveness of clinical pharmacist interventions within a multidisciplinary team in the secondary prevention of CVD, using studies conducted on patients with heart failure, coronary heart disease, or those with CVD risk factors. METHODS: Extensive searches of 13 databases were performed--with no time limitation--to identify randomized controlled trials (RCT) in English that evaluated clinical pharmacist intervention in patients with CVD or with CVD risk factors. Two independent reviewers evaluated 203 citations that were the result of this search. Studies were included if they reported direct care from a clinical pharmacist in CVD or CVD-related therapeutic areas such as disease-led management or in collaboration with other health care workers; if they were RCTs; if they were inpatients, outpatients, or in the community setting; and if they included the following outcomes: CVD control or mortality, CVD risk factor control, patient-related outcomes (knowledge, adherence, or quality of life), and cost related to health care systems. RESULTS: A total of 59 studies were identified: 45 RCT, 6 non-RCT, and 8 economic studies. 68% of the outcomes reported showed that clinical pharmacy services were associated with better improvement in patients' outcomes compared with the control group. CONCLUSION: The involvement of a pharmacist demonstrated an ability to improve CVD outcomes through providing educational intervention, medicine management intervention, or a combination of both. These interventions resulted in improved CVD risk factors, improved patient outcomes, and reduced number of drug-related problems with a direct effect on CVD control. These improvements may lead to an improvement in patient quality of life, better use of health care resources, and a reduced rate of mortality.
Altowaijri et al. (Sat,) conducted a systematic review in Cardiovascular disease (n=59). Clinical pharmacist intervention vs. Control group was evaluated on CVD control or mortality, CVD risk factor control, patient-related outcomes, and cost. Clinical pharmacist interventions in secondary prevention of cardiovascular disease improved patient outcomes compared with control in 68% of the reported outcomes across 59 identified studies.
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