Naslov
Impact of collaborative practice between pharmacists and general practitioners as a key for medication mismanagement of elderly cardiovascular patients

Autori
Brajković A. ; Bićanić, L.A. ; Orehovački, H. ; Ramalho de Oliveira ; Dj. ; Mucalo, I.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
13th Working Conference 2023 ; Pharmaceutical Care Network Europe

Mjesto i datum
Hillerød, Danska, 08.02.2023. - 11.02.2023

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
medication mismanagement, elderly, cardiovascular patients

Sažetak
Background Patients with established cardiovascular disease (CVD) often have multiple medications that increase the risk of prevalence of drug therapy problems (DTP), subsequently leading to unfavourable clinical outcomes and treatment failure. By providing Comprehensive Medication Management (CMM), pharmacists assess patients’ medication-related needs, identify and prevent DTP, develop individualized care plan for each individual patient and evaluate and monitor outcomes. Thus, the CMM services delivered at the primary care level in collaboration with general practitioners can address this problem and by optimizing therapy improve patients’ clinical outcomes and health-related quality of life (HRQoL). Studies have shown that patients with chronic diseases have the greatest benefit from the CMM services. Purpose The objective of this study was to evaluate the impact of CMM services on healthcare utilisation, cardiovascular risk factors and HR QoL among older patients with established CVDs. Method This quasi-experimental study that was performed at the Croatian primary care ambulatory clinic included patients aged 65 to 80 years. Patients were divided into intervention (65 patients) and control groups (68 patients) and were followed-up for one year. Pharmacists provided face-to-face consultations to patients from the intervention group. Groups were compared with regards to the clinical parameters (blood pressure, HbA1c, LDL, TC), healthcare utilisation (hospital admission, emergency visits, unplanned GP visits) and HRQoL.The Euro-Quality of Life Questionnaire 5 Dimensions 5 Levels (EQ-5D-5L) was used to measure the HRQoL at baseline (initial visit) and 12 months following CMM services. Findings The CMM intervention significantly improved systolic blood pressure (p = 0.038), diastolic blood pressure (p = 0.001), total cholesterol (p = 0.014), low-density lipoprotein cholesterol (p = 0.005), and glycosylated haemoglobin (p = 0.045) in comparison with the control group. The number of hospital admissions and unplanned GPs visits were 3.35 (95% CI 1.16 –10.00) and 2.34 (95% CI 1.52–3.57) times higher in the control group compared to the intervention group, respectively. Following the CMM intervention, 65 patients reported significant improvement in dimensions “self-care” (p =0.011) and “usual activities” (p =0.003), whereas no significant change was found in the “mobility” (p = 0.203), “pain/discomfort” (p =0.173) and “anxiety/depression” (p = 0.083) dimensions and the self-rated VAS scale (p = 0.781). Conclusion This study demonstrated that pharmacists providing CMM services can significantly contribute to better clinical outcomes and lower healthcare utilisation, thus potentially contributing to total healthcare savings. As the same time, the obtained results indicated that CMM services may improve patients’ HRQoL.

Izvorni jezik
Engleski

Znanstvena područja
Farmacija

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