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Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis

Title
Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis
Authors
Kang, J. E.Han, N. Y.Oh, J. M.Jin, H. K.Kim, H. A.Son, I. J.Rhie, S. J.
Ewha Authors
이정연
SCOPUS Author ID
이정연scopus
Issue Date
2016
Journal Title
JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS
ISSN
0269-4727JCR Link1365-2710JCR Link
Citation
vol. 41, no. 2, pp. 145 - 157
Keywords
acute coronary syndromeheart failurepharmaceutical carepharmacist
Publisher
WILEY-BLACKWELL
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
What is known and objectiveMany trials have indicated that interventions by pharmacists resulted in beneficial outcomes with positive effects on cardiovascular diseases. The interventions through pharmacist-involved pharmaceutical care in patients with heart failure (HF) and acute coronary syndrome (ACS) were reviewed systemically and examined. MethodsA systematic literature search was conducted to identify relevant articles describing pharmacist interventions in HF and ACS. Most studies were evaluated qualitatively, and the strength of evidence was graded according to the Agency for Healthcare Research and Quality (AHRQ) guidelines. Some of the studies were also assessed by a meta-analysis. ResultsA total of 26 studies containing data on 9415 patients were identified. For all studies, the strength of the body of evidence was reviewed and graded, and 14 studies among them were meta-analysed. The evidence was not strong enough to determine the effects of pharmaceutical care on major and patient-centred outcomes, except the prescription rates of angiotensin-converting-enzyme inhibitors (ACEI) with a high strength of evidence. In the meta-analysis, all-cause hospitalization [odds ratio (OR), 074; 95% confidence interval (CI), 058-094] was reduced and the prescription rates of angiotensin-converting-enzyme inhibitors (ACEI; OR 143; 95% CI, 107-191) and beta-blockers (OR 192; 95% CI, 124-296) were significantly higher in the pharmaceutical care group compared with the usual care group. What is new and conclusionsAll-cause hospitalization showed improvement in the pharmaceutical care group. However, the strength of evidence for the majority of outcomes with pharmaceutical care, except direct performance measures such as prescription rates, was either insufficient or low. This could be explained by the presence of imprecision and inconsistency derived from the diversity of pharmaceutical care, the heterogeneity of patient populations or clinical settings. Moreover, it may indicate the necessity for homogeneous applicable criteria for assessment. A standardized consensus of the guidelines for pharmaceutical care service should be considered to improve homogeneity.
DOI
10.1111/jcpt.12367
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약학대학 > 약학과 > Journal papers
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