Document Detail


Impact of the clinical pharmacist on readmission in patients with acute coronary syndrome.
MedLine Citation:
PMID:  16046491     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have reported a positive impact of pharmacists on care of patients with chronic illnesses. The impact of the clinical pharmacist on hospital readmission in patients with acute coronary syndromes (ACS) has yet to be evaluated, as of this writing. OBJECTIVE: To evaluate the impact of the clinical pharmacist as a direct patient-care team member on cardiac-related readmission in patients admitted to the general cardiology unit with ACS. METHODS: A prospective, nonrandomized observational study compared patients who received standard practice care with patients admitted to a service with a clinical pharmacist to provide care at the bedside. Patients admitted to and discharged from the general cardiology unit for ACS were included. The primary endpoint of the study was cardiac-related readmission at 30 days following hospital discharge. Secondary endpoints included length of stay and medication utilization. Interventions provided by the clinical pharmacist in the study group were documented. RESULTS: Cardiac readmission at 30 days was similar between the groups (p = 0.59). In the subset of patients with unstable angina, readmission in the study group was significantly lower than in the control group (1.3% vs 9.1%; p = 0.04). Patients in both groups were similarly managed using drug therapy and invasive coronary interventions. The medical staff's rate of acceptance of recommendations provided by the pharmacist was 94.4%. The most common interventions were medication education and identification of indicated therapy. CONCLUSIONS: The addition of pharmacists did not decrease readmission in patients with ACS. The finding of significant reduction in readmission in the subset of patients with unstable angina should be considered "hypothesis generating" for future randomized studies to confirm the results.
Authors:
Kate M O'Dell; Suzan N Kucukarslan
Publication Detail:
Type:  Journal Article     Date:  2005-07-26
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  39     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-16     Completed Date:  2005-10-26     Revised Date:  2006-10-13    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1423-7     Citation Subset:  IM    
Affiliation:
Department of Pharmacy, David Grant Medical Center, Thomas J Long School of Pharmacy and Health Sciences, University of the Pacific, Travis Air Force Base, CA 94535-1809, USA. kodell@pacific.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Angina, Unstable / epidemiology,  prevention & control
Coronary Disease / complications,  drug therapy*,  epidemiology
Drug Utilization
Endpoint Determination
Female
Humans
Length of Stay
Male
Middle Aged
Myocardial Infarction / epidemiology,  prevention & control
Patient Care Team
Patient Readmission / statistics & numerical data*
Pharmacists*
Pharmacy Service, Hospital
Recurrence
Regression Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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