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Aim To evaluate the interventions associated with integration of a clinical pharmacist for antiplatelets best utilization and safety as multidisciplinary team approach is recommended to improve patient outcomes. Methods prospective observational study on coronary heart diseases patients (stable angina, unstable angina, MI, post PCI or post CABG) on antiplatelets therapy (single antiplatelet; SAPT, or dual antiplatelet; DAPT) at governmental and private hospitals. Detailing pharmacist-initiated interventions targeting pharmacotherapy optimization (Dose, duplicate and interactions), also adverse effects detection, and hospital re-admission (re-event of coronary insufficiency). Collecting patients' data by interviews and hospital records using validated check list. Statistical software IBM SPSS software package version 20.0, The Kolmogorov-Smirnov was used to verify the normality of distribution of variables, Mann Whitney test was used to compare between two categories for not normally distributed quantitative variables. Kruskal Wallis test was used to compare different categories for abnormally distributed quantitative variables. Spearman coefficient was used to correlate between quantitative variables. Linear Regression was used to detect the most affecting factor for affecting DAPT score and Precise DAPT. Significance of the obtained results was judged at the 5% level, calculate sample size by G Power3. Results There is a significant correlation between cardiac related readmission and Precise DAPT score (P = 0.013).A statistically significant correlation is found between smoking and DAPT score (p = 0.015) but not with precise DAPT (P = 0.152). Also a significant linear association exists between DAPT type and DAPT score, for Aspirin + Clopidogrel (P = 0.010) (95%CI=-1.000 (-1.754 – -0.246), Aspirin + Ticagrilor (P = 0.012) (95%CI= 1.001 (0.228 – 1.774). The highly significant influencing variable in both scores, is the dose value, for DAPT score (P = 0.038), Precise DAPT (P = 0.001). The distribution of Myocardial infarction as cardiac related readmission and smoking are higher in males than females without statistically significant difference (P = 0.08), (P = 0.39), the absence of adverse effects and bleeding events is statistically significant in DAPT score (P = 0.041, 95%CI=1.706 (0.071 – 3.341) &amp; precise DAPT score (P = 0.002, 95% CI= -15.95 (-25.832 – -6.074). Conclusions Impact of a clinical pharmacist within cardiology department generated substantial pharmacotherapy optimization which improve the medication adherence, safety and clinical outcomes. Our study suggests pre-calculating DAPT and precise DAPT for all patients before treatment and commitment on DAPT period administration may decrease re-admission rate of patients.

Prospective Descriptive Study to Evaluate the Impact of Clinical Pharmacist in Antiplatelet Utilization and Safety in Coronary Heart Disease Patients