A prospective study concerning the effect of pharmaceutical care services on patients with heart failure

Year 2022, , 853 - 859, 30.12.2022

Neda Taner , Barkın Berk

https://doi.org/10.33808/clinexphealthsci.895693

Abstract

Objective: Heart failure (HF), caused by an abnormality in cardiac function, is the inability of heart tissue to pump blood or deliver sufficient oxygen, resulting in abnormal diastolic volume. Drug-Related Problems (DRPs) can cause significant but preventable morbidity and mortality once specific medication errors and their contributing factors are identified. The aim of this prospective study is to determine the effect of pharmaceutical care in patients with heart failure in a Turkish hospital.
Methods: A total of 160 patients with heart failure (80 patients in the control group, 80 patients in the intervention group) were examined at a university hospital. The results of the Pharmaceutical Care Survey were evaluated in accordance with the objective of the study. In addition, using the Pharmaceutical Care Network Europe (PCNE) classification system V8.01, the role and importance of the clinical pharmacist in identifying, preventing and resolving drug-related problems encountered during the treatment of two groups was assessed. The number and causes of potential DRPs were taken into scrutiny.
Results: Comparing the results of the Pharmaceutical Care Survey in both groups at the end of the 6th month, the study group shows a
significant improvement in the rates of “forgetting to take medication” (2.9%) and “experiencing any side effects from your drug” (4.5%). Compared to other problems, ineffectiveness of the drugs used in treatment was reported as the most common drug-related problem (n=23; 28.7%) in the study group (p<.05). 72.5% of the proposed interventions were accepted and the problem was found to be resolved in 31% of the patients.
Conclusion: In this study, it is discussed that clinical pharmacists can play an active role in resolving DRPs in heart failure patients. It is therefore can be predicted that the training of information and warnings conveyed by the clinical pharmacist to the intervention group will make a significant contribution to the health of the patient within the framework of pharmaceutical care.

Keywords

Clinical Pharmacy, Drug-related problem, Heart Failure, Pharmaceutical Care

References

• [1] McNeely EB. Treatment considerations and the role of the clinical pharmacist throughout transitions of care for patients with acute heart failure. J Pharm Pract. 2017;30(4):441-450.
• [2] Figueroa MS, Peters JI. Congestive heart failure: Diagnosis, pathophysiology, therapy, and implications for respiratory care. Respir Care 2006;51(4):403-412.
• [3] Alemzadeh-Ansari MJ, Ansari-Ramandi MM, Naderi N. Chronic pain in chronic heart failure: A review article. J Tehran Univ Hear Cent. 2017;12(2):49–56.
• [4] Azad N, Lemay G. Management of chronic heart failure in the older population. J Geriatr Cardiol. 2014;11(4):329-337.
• [5] Jaarsma T, Strömberg A, Mårtensson J, Dracup K. Development and testing of the European Heart Failure Self-Care Behaviour Scale. Eur J Heart Fail. 2003;5(3):363-370.
• [6] Wiffen P, Mitchell M, Snelling M. Oxford Handbook of Clinical Pharmacy. Third edit. OUP Oxford 2017; p342-347.
• [7] Viktil KK, Blix HS. The impact of clinical pharmacists on drug related problems and clinical outcomes. Basic Clin Pharmacol Toxicol. 2008; 102(3):275-280.
• [8] Reddenna L, Nagavalli S. Drug therapy problems: A review of literature. PharmaTutor 2014;2(2):111–116.
• [9] Adriano LS, Martins BCC, Lima LF, Cavalcante RM de A, De Oliveira FRP, Magalhães VP, Firmino PYM, Fonteles MMF, Neri EDR. Pharmaceutical interventions and their clinical outcomes in an inpatient post-transplant unit. Rev. Bras. Farm. Hosp. Serv. Saúde São Paulo 2017; 8(1):15–21.
• [10] Van den Bemt P, Egberts A. Drug-related problems: definitions and classification. EJHP Practice 2007;13(1):62–64.
• [11] PCNE. Classification for Drug related problems. Pharmaceutical Care Network Europe Foundation Classification 2017. Available at https://www.pcne.org/upload/files/230_PCNE_ classification_V8-02.pdf.
• [12] Yeşildağ O, Karatas P, Özben Sadıç B, Izzettin FV. The effect of statin treatment on inflammation and quality of life in patients with heart failure. Int J Cardiol. 2010; Abstract OP 140: 540.
• [13] Kerr A, Strawbridge J, Kelleher C, Mertens F, Pype P, Deveugele M, Pawlikowska T. How can pharmacists develop patient pharmacist communication skills? A realist review protocol. Syst Rev. 2017; 23;6(1):14.
• [14] Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist review–a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy. 2005;10 (Suppl 1):21– 34.
• [15] Roblek T, Deticek A, Leskovar B, Suskovic S, Horvat M, Belic A, Mrhar A, Lainscak M. Clinical-pharmacist intervention reduces clinically relevant drug-drug interactions in patients with heart failure: A randomized, double-blind, controlled trial. Int J Cardiol. 2016;203:647–652.
• [16] Sadik A, Yousif M, McElnay JC. Pharmaceutical care of patients with heart failure. Br J Clin Pharmacol. 2005;60(2):183-193.
• [17] Varma S, McElnay JC, Hughes CM, Passmore AP, Varma M. Pharmaceutical care of patients with congestive heart failure: interventions and outcomes. Pharmacotherapy 1999;19(7):860-869.
• [18] Chambela M da C, Mediano MFF, Carneiro FM, Ferreira RR., Waghabi MC, Mendes VG, Oliveira LS, de Holanda MT, de Sousa AS, da Costa AR, Xavier SS, da Silva GMS, Saraiva RM. Impact of pharmaceutical care on the quality of life of patients with heart failure due to chronic Chagas disease: Randomized clinical trial. Br J Clin Pharmacol. 2020;86(1):143–154.
• [19] Winterstein AG, Sauer BC, Hepler CD, Poole C. Preventable drug-related hospital admissions. Ann Pharmacother. 2002;36(7-8):1238-1248.
• [20] Shastry S, Prudhivi RSV, Lugun A, Mounika TS, Christopher S. Pattern of Pharmacotherapy and Assessment of Drug Related Problems in Ischemic Heart Disease Patients. Int Res J Pharm. 2019;10(3):136–143.
• [21] Peterson C, Gustafsson M. Characterization of drug-related problems and associated factors at a clinical pharmacist service-naïve hospital in Northern Sweden. Drugs Real World Outcomes. 2017;4(2):97-107
• [22] Dempsey JT, Matta LS, Carter DM, Stevens CA, Stevenson LW, Desai AS, Cheng JW. Assessment of drug therapy-related issues in an outpatient heart failure population and the potential impact of pharmacist-driven intervention. J Phar