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Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study

BACKGROUND: Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity in Qatar and globally. AIM: The primary objective of the study was to evaluate the effectiveness of a structured clinical pharmacist-delivered intervention on all-cause hospitalizations and cardiac-related readmi...

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Autores principales: El Hajj, Maguy Saffouh, Kaddoura, Rasha, Abu Yousef, Safae E. A., Orabi, Bassant, Awaisu, Ahmed, AlYafei, Sumaya, Shami, Rula, Mahfoud, Ziyad R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250427/
https://www.ncbi.nlm.nih.gov/pubmed/36795303
http://dx.doi.org/10.1007/s11096-023-01538-4
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author El Hajj, Maguy Saffouh
Kaddoura, Rasha
Abu Yousef, Safae E. A.
Orabi, Bassant
Awaisu, Ahmed
AlYafei, Sumaya
Shami, Rula
Mahfoud, Ziyad R.
author_facet El Hajj, Maguy Saffouh
Kaddoura, Rasha
Abu Yousef, Safae E. A.
Orabi, Bassant
Awaisu, Ahmed
AlYafei, Sumaya
Shami, Rula
Mahfoud, Ziyad R.
author_sort El Hajj, Maguy Saffouh
collection PubMed
description BACKGROUND: Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity in Qatar and globally. AIM: The primary objective of the study was to evaluate the effectiveness of a structured clinical pharmacist-delivered intervention on all-cause hospitalizations and cardiac-related readmissions in patients with ACS. METHOD: A prospective quasi-experimental study was conducted at Heart Hospital in Qatar. Discharged ACS patients were allocated to one of three study arms: (1) an intervention group (received a structured clinical pharmacist-delivered medication reconciliation and counselling at discharge, and two follow-up sessions at 4 weeks and 8 weeks post-discharge), (2) a usual care group (received the general usual care at discharge by clinical pharmacists) or, (3) a control group (discharged during weekends or after clinical pharmacists' working hours). Follow-up sessions for the intervention group were designed to re-educate and counsel patients about their medications, remind them about the importance of medication adherence, and answer any questions they may have. At the hospital, patients were allocated into one of the three groups based on intrinsic and natural allocation procedures. Recruitment of patients took place between March 2016 and December 2017. Data were analyzed based on intention-to-treat principles. RESULTS: Three hundred seventy-three patients were enrolled in the study (intervention = 111, usual care = 120, control = 142). Unadjusted results showed that the odds of 6-month all-cause hospitalizations were significantly higher among the usual care (OR 2.034; 95% CI: 1.103–3.748, p = 0.023) and the control arms (OR 2.704; 95% CI: 1.456–5.022, p = 0.002) when compared to the intervention arm. Similarly, patients in the usual care arm (OR 2.304; 95% CI: 1.122–4.730, p = 0.023) and the control arm (OR 3.678; 95% CI: 1.802–7.506, p ≤ 0.001) had greater likelihood of cardiac-related readmissions at 6 months. After adjustment, these reductions were only significant for cardiac-related readmissions between control and intervention groups (OR 2.428; 95% CI: 1.116–5.282, p = 0.025). CONCLUSION: This study demonstrated the impact of a structured intervention by clinical pharmacists on cardiac-related readmissions at 6 months post-discharge in patients post-ACS. The impact of the intervention on all-cause hospitalization was not significant after adjustment for potential confounders. Large cost‐effective studies are required to determine the sustained impact of structured clinical pharmacist-provided interventions in ACS setting. TRIAL REGISTRATION: Clinical Trials: NCT02648243 Registration date: January 7, 2016.
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spelling pubmed-102504272023-06-10 Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study El Hajj, Maguy Saffouh Kaddoura, Rasha Abu Yousef, Safae E. A. Orabi, Bassant Awaisu, Ahmed AlYafei, Sumaya Shami, Rula Mahfoud, Ziyad R. Int J Clin Pharm Research Article BACKGROUND: Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity in Qatar and globally. AIM: The primary objective of the study was to evaluate the effectiveness of a structured clinical pharmacist-delivered intervention on all-cause hospitalizations and cardiac-related readmissions in patients with ACS. METHOD: A prospective quasi-experimental study was conducted at Heart Hospital in Qatar. Discharged ACS patients were allocated to one of three study arms: (1) an intervention group (received a structured clinical pharmacist-delivered medication reconciliation and counselling at discharge, and two follow-up sessions at 4 weeks and 8 weeks post-discharge), (2) a usual care group (received the general usual care at discharge by clinical pharmacists) or, (3) a control group (discharged during weekends or after clinical pharmacists' working hours). Follow-up sessions for the intervention group were designed to re-educate and counsel patients about their medications, remind them about the importance of medication adherence, and answer any questions they may have. At the hospital, patients were allocated into one of the three groups based on intrinsic and natural allocation procedures. Recruitment of patients took place between March 2016 and December 2017. Data were analyzed based on intention-to-treat principles. RESULTS: Three hundred seventy-three patients were enrolled in the study (intervention = 111, usual care = 120, control = 142). Unadjusted results showed that the odds of 6-month all-cause hospitalizations were significantly higher among the usual care (OR 2.034; 95% CI: 1.103–3.748, p = 0.023) and the control arms (OR 2.704; 95% CI: 1.456–5.022, p = 0.002) when compared to the intervention arm. Similarly, patients in the usual care arm (OR 2.304; 95% CI: 1.122–4.730, p = 0.023) and the control arm (OR 3.678; 95% CI: 1.802–7.506, p ≤ 0.001) had greater likelihood of cardiac-related readmissions at 6 months. After adjustment, these reductions were only significant for cardiac-related readmissions between control and intervention groups (OR 2.428; 95% CI: 1.116–5.282, p = 0.025). CONCLUSION: This study demonstrated the impact of a structured intervention by clinical pharmacists on cardiac-related readmissions at 6 months post-discharge in patients post-ACS. The impact of the intervention on all-cause hospitalization was not significant after adjustment for potential confounders. Large cost‐effective studies are required to determine the sustained impact of structured clinical pharmacist-provided interventions in ACS setting. TRIAL REGISTRATION: Clinical Trials: NCT02648243 Registration date: January 7, 2016. Springer International Publishing 2023-02-16 2023 /pmc/articles/PMC10250427/ /pubmed/36795303 http://dx.doi.org/10.1007/s11096-023-01538-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
El Hajj, Maguy Saffouh
Kaddoura, Rasha
Abu Yousef, Safae E. A.
Orabi, Bassant
Awaisu, Ahmed
AlYafei, Sumaya
Shami, Rula
Mahfoud, Ziyad R.
Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_full Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_fullStr Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_full_unstemmed Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_short Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_sort effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250427/
https://www.ncbi.nlm.nih.gov/pubmed/36795303
http://dx.doi.org/10.1007/s11096-023-01538-4
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