ORCID Profile
0000-0002-5337-8061
Current Organisations
Monash University
,
Ballarat Health Services
,
Grampians Health
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Publisher: Springer Science and Business Media LLC
Date: 20-03-2023
DOI: 10.1007/S11096-023-01562-4
Abstract: Adherence to secondary prevention medications following acute coronary syndromes (ACS) is a predictor of future major adverse cardiovascular events. Underutilisation of these medications is associated with higher risk of major adverse cardiovascular events globally. To explore the effects of a telehealth cardiology pharmacist clinic on patient adherence to secondary prevention medications in the 12 months following ACS. Retrospective matched cohort study within a large regional health service comparing patient populations before and after implementation of pharmacist clinic with 12-month follow up. Patients who received percutaneous coronary intervention for ACS were consulted by the pharmacist at 1, 3- and 12-months. Matching criteria included age, sex, presence of left ventricular dysfunction and ACS type. Primary outcome was difference in adherence in adherence at 12 months post ACS. Secondary outcomes included major adverse cardiovascular events at 12 months and validation of self-reported adherence using medication possession ratios from pharmacy dispensing records. There were 156 patients in this study (78 matched pairs). Analysis of adherence at 12 months demonstrated an absolute increase in adherence by 13% (31 vs. 44%, p = 0.038). Furthermore, sub-optimal medical therapy (less than 3 ACS medication groups at 12 months) reduced by 23% (31 vs. 8%, p = 0.004). This novel intervention significantly improved adherence to secondary prevention medications at 12 months, a demonstrated contributor to clinical outcomes. Primary and secondary outcomes in the intervention group were both statistically significant. Pharmacist-led follow up improves adherence and patient outcomes.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Elsevier BV
Date: 03-2023
Publisher: Research Square Platform LLC
Date: 27-10-2022
DOI: 10.21203/RS.3.RS-2139967/V1
Abstract: Background: Optimal medical therapy (OMT) following acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI) is a predictor of future major adverse cardiovascular events (MACE). Underutilisation of OMT is associated with higher risk of MACE within Australian populations. Aims: Effects of a telehealth cardiology pharmacist clinic (TCPC) on patient adherence to OMT and MACE in patients who received PCI for ACS. Methods: Retrospective matched cohort study within a large regional health service comparing patient populations before and after implementation of post-PCI TCPC with twelve-month follow up. Patients who received PCI for ACS were consulted by the pharmacist at one, three- and twelve-months’. Matching criteria included age, sex, presence of left ventricular dysfunction and ACS type. Primary outcome was difference in adherence to OMT at twelve months post PCI. Secondary outcomes included 4-point MACE at twelve months and validation of self-reported adherence using medication possession ratios from pharmacy dispensing records. Results: There were 156 patients in this study (78 matched pairs). Analysis of adherence to OMT at twelve months demonstrated an absolute increase in adherence to OMT by 13% (31 vs. 44%, p = 0.038). Furthermore, sub-optimal medication therapy (less than ACS medication groups at twelve months) reduced by 23% (31–8%, p = 0.004). MACE at twelve months reduced by 23% (31 vs.8% p = 0.004). Conclusions: This novel intervention significantly improved adherence at to OMT at twelve months a demonstrated contributor to clinical outcomes. Primary and secondary outcomes in the intervention group were both statistically significant. Pharmacist-led follow up is both cost effective and improves patient outcomes.
No related grants have been discovered for Adam Livori.