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Study finds cardiac day ward pharmacists can optimise medication management

Cardiac day ward pharmacists help to improve medication safety through reviews and communicating any treatment changes to primary care providers, a new study has concluded.

In a quality improvement project evaluating the role of clinical pharmacists in cardiac day wards, researchers sought to explore the extent to which pharmacists could optimise medicine management and facilitate implementation and communication of any medication changes at hospital discharge to primary care physicians.

As the medicine experts, pharmacists are able to undertake the best possible medication history (BPMH) and provide medication reconciliation services for cardiology patients. However, limited evidence exists on the role and value of a cardiac day ward pharmacist.

Published in the International Journal of Pharmacy Practice, the evaluation focused on all aspects of medicine use, documentation of post-procedure medication plans and resolution of medication-related problems (MRPs). For the study, MRPs were deemed to be any medicine-related circumstance that might interfere with the desired health outcome. This wide ranging definition encompassed assessment of medicine omissions, drugs prescribed and/or administered incorrectly and any relevant interactions or contraindications.

For the purpose of the evaluation, the primary outcome measures included the proportion of patients on the cardiac day wards who received medication review, BPMHs, documenting post-procedure medication plans and the number of MRPs. A key secondary outcome was the number of MRPs accepted and resolved.

Significant increase

A total of 297 cardiac day ward patients with a mean age of 63 years (65% male) had usable data.

Overall, 80% of patients had a medication review and 65% a BPMH. Some 90 MRPs were identified, representing an average of 0.3 MRPs per patient. Comparing standard catheterisation laboratory documentation without pharmacist input, use of a pharmacist significantly increased documentation of medication plans at the time of discharge (20% vs 95%, p < 0.001).

The majority of MRPs (77%) occurred in patients admitted for coronary angiography/angioplasty. Overall, medical staff accepted 93% pharmacist recommendations. The most common MRP (29%) was when a medicine was indicated but not prescribed.

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