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Management of pharmacotherapy-related problems in acute coronary syndrome: role of clinical pharmacist in cardiac rehabilitation unit.

Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and negatively impacts health care costs, productivity and quality of life. Poly-morbidity and poly-pharmacy predispose ACS patients to medication discrepancies between cardiologist-prescribed medication and drug use by the patient, drug-related problems (DRPs) and inadequate drug adherence. This study aimed to evaluate the impact of clinical pharmacist-provided services on the outcome of ACS patients. This was a prospective, randomised, controlled study on ACS patients participating in a cardiac rehabilitation program. Forty ACS patients were randomly assigned to either; control group, received standard medical care or; intervention group, received standard medical care plus clinical pharmacist-provided services. Services included DRPs management, clinical assessment and enforcing the patient education and adherence. For both groups, the following was assessed at baseline and after 3 months; DRPs, adherence (assessed by 8-item morisky adherence questionnaire), patient's knowledge (assessed by coronary artery disease questionnaire), 36-Short Form health survey (SF-36), heart rate, systolic and diastolic blood pressure, low density lipoprotein (LDL), total cholesterol (TC) and fasting blood glucose (FBG). After 3 months, there was a significant difference between the intervention and control groups in the % change of: DRPs (median: -100 versus 5.882, p=0.0001), patient's adherence score (median: 39.13 versus -14.58, p=0.0001), knowledge score (median: 30.28 versus -5.196, p=0.0001), SF-36 scores, heart rate (mean: -10.04 versus 6.791, p=0.0001), diastolic blood pressure (mean: -17.87 versus 10.45, p=0.0001), systolic blood pressure (mean: -16.22 versus 4.751, p=0.0001), LDL (median: -25.73 versus -0.2538, p=0.0071), TC (median: -14.62 versus 4.123, p=0.0005) and FBG (median: -11.42 versus 5.422, p=0.0098). Clinical pharmacists can play an important role as part of a cardiac rehabilitation team through patient education and interventions to minimize DRPs. This article is protected by copyright. All rights reserved.

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