Coronary Heart Disease Clinical Trial
Official title:
Development of a Standardized Clinical Pharmacist Service for Patients Discharged From Hospital. Measurement of Drug Prescribing Quality in Secondary Prevention of Coronary Heart Disease Utilizing a Medication Assessment Tool (MAT-CHDsp)
Objectives To explore the impact of a clinical pharmacist-led 12 month lasting follow-up
program for patients with established coronary heart disease (CHD) discharged from the North
Norway University Hospital. Methods A total of 102 patients aged 18-82 years were enrolled in
a non-blinded, randomized controlled trial. The intervention comprised medication
reconciliation, medication review and patient education during three meetings; at discharge,
after three months and after twelve months. The control group received standard care from
their general practitioner. Primary outcomes were adherence to clinical guideline
recommendations concerning prescription, therapy goal achievement and lifestyle education
defined in the medication assessment tool for secondary prevention of CHD (MAT-CHDSP).
Secondary outcomes included changes in the biomedical risk factors cholesterol, blood
pressure and blood glucose. Key findings Ninety-four patients completed the trial, 48
intervention group patients and 46 controls.
Appropriate prescribing was high, but therapy goal achievement was low in both study groups
throughout the study. Overall adherence to MAT-CHDSP criteria increased in both groups and
was significantly higher in the intervention group at study end compared to the control
group, 78.1% vs. 61.4%, P < 0.001. The difference was mainly due to an increased
documentation of lifestyle advices in intervention group patients.
No significant improvements in biomedical risk factors were observed in favor of the
intervention group, possible due to an underpowered study. Conclusion The clinical
pharmacist-led follow-up program significantly increased documented lifestyle advices defined
in the MAT-CHDSP for the intervention group, but did not lead to significant improvements in
biomedical risk factor measures in favor of the intervention group. Even if prescribing was
high, therapy goal achievement was low in both study groups. Changes to the follow-up program
are warranted, in addition to a larger, adequately powered study, before implementation in
standard patient care can be recommended.
Find published article in Pharm Pract (Granada). 2015 Apr-Jun; 13(2): 575. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482847/pdf/pharmpract-13-575.pdf ;
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