Clinical Pharmacist’s Intervention to Improve Medication Titration for Heart Failure: First Experience from Sudan

Ahmed, Kannan O.; Eldin, Imad Taj; Yousif, Mirghani; Albarraq, Ahmed A.; Yousef, Bashir A.; Ahmed, Nasrein; Babiker, Anas

doi:10.2147/iprp.s341621

Cited by 4 publications

(4 citation statements)

References 28 publications

(36 reference statements)

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“…Our study shared similarities with previous Sudanese studies with regard to the mean age of HF patients, and that diabetes and hypertension were the main comorbid disease in HF [17,18]. On the other hands, 77% of patients were on Beta blockers, and 55.5% on ARBs or ACEIs this is lower than what had been reported [19], this might be due to the source of information in this study primarily depending on patients.…”

Section: Discussionsupporting

confidence: 87%

Self-care Behaviors among Sudanese Patients with Heart Failure: A Cross-sectional Assessment

Ahmed

Abdelmaged²,

Ibrahim³

et al. 2022

JPRI

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Background: Selfcare is a vital component of heart failure management that is known to improve the outcomes. However, little is known about the status of self-care behaviors among patients with heart failure in Sudan. Objectives: This study aimed to assess the self-care behaviors among Sudanese patients with heart failure at a tertiary hospital in Sudan. Methods: A cross-sectional single-institutional study was conducted across three-month period in 2021. A total of 200 heart failure patients were enrolled, and data was collected through patients’ interview. Descriptive and binary logistic regression analyses were processed to check the effect of different factors on the patients’ adherence levels. Results: Out of 200 heart failure patients, 53.5% were females, and the mean age of patients was 60 (± 13.7 SD) years. Among them, only 4.5% of heart failure patients reported adequate adherence to their self-care recommendations and the mean total score was 42.6 (± SD15.5). Adherence to self-care recommendations wasn’t significantly associated with age, gender, marital status, education level, and comorbidity. Conclusion: In this study, the overall adherence to self-care behavior was found to be extremely low among Sudanese heart failure patients, and selectively adherence to prescribed medications was good. These outcomes put light on a major opportunity for further prospective follow–up studies, which have an intervention approach for each self–care recommendation to improve the heart failure situation in Sudan.

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Section: Discussionsupporting

confidence: 87%

Self-care Behaviors among Sudanese Patients with Heart Failure: A Cross-sectional Assessment

Ahmed

Abdelmaged²,

Ibrahim³

et al. 2022

JPRI

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“…Moreover, there is a great opportunity to optimize care for patients with cardiovascular disease including ACS by addition of a clinical pharmacist to the multidisciplinary team at Medani Heart Center, who showed positive impact in anticoagulation clinic and heart failure clinic in other cardiac centers in Khartoum, Sudan. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Optimal Medical Therapy for Secondary Prevention of Acute Coronary Syndrome: A Retrospective Study from a Tertiary Hospital in Sudan

Ahmed¹,

Ahmed²,

Wali³

et al. 2022

TCRM

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Background Five-medication regimen is recommended for patients after acute coronary syndrome (ACS) as a secondary prevention strategy at discharge to reduce recurrence and improve mortality. Objective This study aimed to assess prescribing of optimal medical therapy (OMT) as five-medication regimens for secondary prevention at discharge after ACS in Sudan. Methods A retrospective cohort study was performed at a tertiary hospital located in Wad Medani, Sudan, in the period between January and December 2019. Data were collected from patients’ files. OMT was defined as a combination of five medications; aspirin and P2Y12 inhibitors, statins, beta-blockers (BBs), and angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) or if a valid contraindication was documented. Results Of the 619 patients throughout the study period, 591 were selected based on inclusion and exclusion criteria. The median age of patients was 60 years, and 58.9% of patients were male. Diabetes (44.5%) and hypertension (42%) were the most common risk factors. Most patients (58.4%) were diagnosed with ST-segment elevation myocardial infarction. About 99.7% of patients were on aspirin, 99.5% on statins, 97% on clopidogrel, 96.8% on dual antiplatelet therapy, 70.4% on BBs, and 57.9% on ACEIs/ARBs. OMT for secondary prevention was prescribed to 267 (45.2%) patients with ACS at discharge. Conclusion Although prescriptions for all five guideline-recommended medications after ACS were suboptimal, the study showed a positive trend in prescribing most individual medications.

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“…Switching between CV drugs is primarily performed in HTN and HF, which indicates the presence of a gap in following the guideline recommendations for managing HTN. A study in Sudan (published in 2021) at the HF clinic showed a significant role for the clinical pharmacist in the optimization of guideline-directed medical therapy, such as drug initiation, up-titration, cessation, and switching with improvement in LVEF and NYHA classes ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular drug interventions in the cardio-oncology clinic by a cardiology pharmacist: ICOP-Pharm study

Yaseen

Farhan²

2022

Front. Cardiovasc. Med.

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BackgroundCardio-oncology is a rapidly growing field that requires a novel service design to deal with the increasing number of patients. It is reported that the volume of patients at the cardio-oncology clinic in the United Kingdom is 535 patients/5 years and in Canada is 779 patients/7 years. The pharmacist has a role in reducing the consultation time of physicians.ObjectiveTo identify the role of a qualified cardiology pharmacist at the cardio-oncology clinic using a new paradigm based on complementary interventions with the cardiologist for the management of patients with cancer and cardiovascular risk factors and/or cardiovascular diseases (CVRF/CVD).MethodsA prospective observational study was conducted at the cardio-oncology clinic in the Medical City in Baghdad, Iraq between December 2020 and December 2021. Patients with CVRF/CVD were registered. The Iraqi Cardio-Oncology Program-Pharmacist (ICOP-Pharm) paradigm was designed to involve a qualified cardiology pharmacist for initial cardiovascular (CV) drug interventions.ResultsAmong 333 patients who attended our clinic over the 1-year interval, 200 (60%) CVRF/CVD cases were enrolled in the study, and of them 79 (40%) patients had CV drug interventions. A total of 196 interventions were done, including 147 (75%) cases performed by the cardiology pharmacist, and 92 (63%) of the latter were CV drug initiations. Among the total CVRF/CVD treated initially by the cardiology pharmacist, hypertension 32 (26%) and cancer therapy-related cardiac dysfunction 29 (24%) were the main types.ConclusionThe qualified cardiology pharmacist was responsible for three-quarters of the initial CV drug interventions at the cardio-oncology clinic in a complementary approach to the cardiologist. The role of the cardiology pharmacist in the ICOP-Pharm paradigm may be one of the reasons for the ability of the heart team to manage 3-fold of the patient volume when compared with those in the United Kingdom or Canada.

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Clinical Pharmacist’s Intervention to Improve Medication Titration for Heart Failure: First Experience from Sudan

Cited by 4 publications

References 28 publications

Self-care Behaviors among Sudanese Patients with Heart Failure: A Cross-sectional Assessment

Self-care Behaviors among Sudanese Patients with Heart Failure: A Cross-sectional Assessment

Optimal Medical Therapy for Secondary Prevention of Acute Coronary Syndrome: A Retrospective Study from a Tertiary Hospital in Sudan

Cardiovascular drug interventions in the cardio-oncology clinic by a cardiology pharmacist: ICOP-Pharm study

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