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Impact of discharge education by clinical pharmacists on patients' adherence to post‐percutaneous coronary intervention medications: A retrospective cohort study using real‐world data
Author(s) -
Rahhal Alaa,
Mahfouz Ahmed,
AlAmri Maha,
Aljundi Amer,
Khir Fadi,
Hamid Yousra,
Alyafei Sumaya,
Arabi Abdul Rahman
Publication year - 2021
Publication title -
journal of the american college of clinical pharmacy
Language(s) - English
Resource type - Journals
ISSN - 2574-9870
DOI - 10.1002/jac5.1369
Subject(s) - medicine , percutaneous coronary intervention , clopidogrel , conventional pci , aspirin , retrospective cohort study , myocardial infarction , medical prescription , odds ratio , statin , cohort , cohort study , context (archaeology) , propensity score matching , population , confidence interval , emergency medicine , nursing , paleontology , environmental health , biology
Background Secondary prevention post myocardial infarction by optimizing secondary prevention cardiovascular medications is important; however, adherence to these medications is essential to achieve benefits. Nevertheless, the impact of education provided by clinical pharmacists to patients post primary percutaneous coronary intervention (PCI) has not yet been evaluated in a real‐world context. Methods This retrospective observational cohort study aimed to assess the impact of education provided by clinical pharmacists compared with other health care providers on adherence to post‐PCI medications and clinical outcomes among patients with ST‐elevation myocardial infarction (STEMI). This study included all patients admitted with STEMI to Heart Hospital in Qatar between 1 January 2016 and 31 December 2018. Adherence was assessed by medication availability 80% of the time, which was monitored by the rate of prescription refill in the year after discharge. Results A total of 1334 patients were included. The majority of patients included were male (96%) and Asian (78%), with a mean age of 51 years. Only 26% of the study population were educated by clinical pharmacists, while the remaining were educated by other health care professionals upon discharge. Adherence to aspirin, P2Y12 inhibitors, statins, and beta‐blockers was significantly better among patients who were educated by clinical pharmacists (aspirin, 59% vs 47%; adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1‐1.9; P = .002; P2Y12 inhibitor, 58% vs 47%; aOR, 1.5; 95% CI, 1.1‐1.9; P = .004; statin, 55% vs 46%; aOR, 1.3; 95% CI, 1.0‐1.7; P = .038; beta‐blocker, 46% vs 37%; aOR, 1.4; 95% CI, 1.1‐1.8; P = .018). However, there was no difference in re‐hospitalization for acute coronary syndrome or all‐cause mortality among patients who were educated by clinical pharmacists upon discharge compared with those who were educated by other health care providers. Conclusion Medication counseling provided by clinical pharmacists significantly improved adherence to post‐PCI medications among patients with STEMI.