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The Extended Role of the Clinical Pharmacist in the Management of Heart Failure and Acute Coronary Syndromes
Author(s) -
Coombes Ian D,
Sanders Daniela CJ,
Thiele Justine M,
Cottrell W Neil,
Stowasser Danielle A,
Denaro Charles,
Scott Ian A
Publication year - 2002
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/jppr200232117
Subject(s) - medicine , intensive care medicine , acute coronary syndrome , pharmacist , psychological intervention , clinical pharmacy , pharmaceutical care , heart failure , intervention (counseling) , multidisciplinary approach , pharmacotherapy , medical emergency , nursing , pharmacy , myocardial infarction , social science , sociology
Aim: To discuss the evidence‐based rationale behind the use of clinical pharmacists in the Brisbane Cardiac Consortium Clinical Support Systems Project (CSSP), and detail the pharmacist‐specific interventions that have been implemented. Background: Congestive heart failure (CHF) and acute coronary syndrome (ACS) are two commonly encountered conditions in hospitalised patients, and are associated with a significant morbidity and mortality. Despite the existence of effective therapies such as angiotensin converting enzyme inhibitors, P‐blockers and lipid lowering agents a dissonance persists between evidence‐based recommendations and routine practice. Multiple factors are responsible for this evidence‐practice gap which results in potentially unnecessary admissions due to suboptimally treated disease. These factors include inappropriate drug prescribing and poor patient compliance which, in varying measures, are attributable to inadequate communication of treatment plans to patients and their carers, general practitioners and community pharmacists. Intervention: Research pharmacists optimise pharmaceutical care using a model that spans all stages of patient care. These pharmacists are involved in admission assessment, optimisation of inpatient therapy, discharge education, implementation of self management plans, enhanced medication liaison and post discharge follow up. Recommendations: Available evidence and experience gained from this project may support further development of specialised clinical pharmacist positions attached to multidisciplinary teams and may be applicable to other chronic diseases.