Comparison of Adherence to the 2013 ACC/AHA Cholesterol Guideline in a Teaching Versus Nonteaching Outpatient Clinic

Cheng-Lai, Angela; Snead, Jessica; Ng, Christina; Verges, Caroline; Chung, Philip

doi:10.1177/1060028017739325

Cited by 3 publications

(1 citation statement)

References 19 publications

(33 reference statements)

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“…Pharmacist interventions can take a leading role in facilitating adherence to perioperative antibiotic prophylaxis guidelines in Africa and improving adherence to recommended amiodarone monitoring guidelines . However, it was also reported that pharmacist intervention did not increase adherence to guideline‐directed statin therapy, and pharmacist intervention did not significantly affect prescribers' adherence rate to the 2013 American college of cardiology/American heart association cholesterol guideline . To the best of our knowledge, no pharmacist‐led intervention on TXA treatment has been reported, besides one pre‐hospital administration protocol where the pharmacist was responsible for expediting the delivery of TXA to the trauma bay …”

Section: Introductionmentioning

confidence: 99%

Effect of pharmacist intervention on blood conservation therapy in total knee arthroplasty: A retrospective, observational study

Zhou

Bao

2019

Basic Clin Pharma Tox

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Background: Total knee arthroplasty (TKA) is associated with blood loss and an increased risk of transfusion. Guidelines for antifibrinolytic drug tranexamic acid (TXA) treatment in TKA patients are available. We evaluated the effects of anticoagulant pharmacist intervention on perioperative blood conservation treatment in TKA patients. Methods: In a retrospective, observational experimental study, patients admitted for TKA were allocated into the control or pharmacist intervention group. In the intervention phase, multiple interventions of TXA treatment based on guidelines were implemented. The primary endpoint was blood loss. Other outcome included postoperative haemoglobin and haematocrit levels, allogeneic blood transfusion, cost savings and safety. Results: A total of 177 patients were included (88 and 89 in the control and intervention group, respectively). In the intervention group, 24.72% orders of TXA dosage, 20.22% orders of drug choice, 26.97% orders of TXA timing and 30.34% orders of TXA administration manner were adjusted. Eighty-nine (100%) patients received blood conservation therapy compared with 21 (23.86%) patients in the control group (P < 0.001). Total blood loss was 1133.31 ± 627.08 mL in the control group compared with 604.34 ± 459.09 mL in the intervention group (P < 0.001). Postoperative drops in haemoglobin and haematocrit in the control group were greater than in the intervention group (P < 0.001). The rate of allogeneic blood transfusion was 40.91% in the control group compared with 21.35% in the intervention group (P = 0.01). Pharmacist intervention was conducted to cost savings resulting from reduced transfusion, but with comparable safety profile. Conclusions: Anticoagulant pharmacist intervention on blood conservation treatment of TKA patients leads to favourable clinical and economic outcome.allogeneic blood transfusion, blood conservation, pharmacist intervention, tranexamic acid, venous thromboembolism Abbreviations: BMI, body mass index; DVT, deep vein thrombosis; Hb, haemoglobin; Hct, haematocrit; TKA, total knee arthroplasty; TXA, tranexamic acid; VTE, venous thromboembolism.

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Section: Introductionmentioning

confidence: 99%

Effect of pharmacist intervention on blood conservation therapy in total knee arthroplasty: A retrospective, observational study

Zhou

Bao

2019

Basic Clin Pharma Tox

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Profile of use and access to statins in patients with coronary arterial disease in an outpatient clinic of a teaching hospital

Veloso

Cruzeiro

Dias

et al. 2020

Current Medical Research and Opinion

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US Antiarrhythmic Drug Treatment for Patients With Atrial Fibrillation: An Insurance Claims–Based Report

Tardos

Ronk

Patel

et al. 2021

JAHA

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Background Current American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines and European Society of Cardiology guidelines recommend antiarrhythmic drugs (AADs) for maintenance of sinus rhythm in patients with atrial fibrillation. We assessed the concordance between healthcare provider real‐world practice and current guidelines with respect to first‐line AAD rhythm management. Methods and Results Administrative claims data from the deidentified Optum Clinformatics Data Mart database were used. Patients were included if they were initiated on an AAD in 2015 to 2016, had 1 year of continuous data availability before their first AAD pharmacy claim, and had a diagnosis for atrial fibrillation within that period. Concordance was assessed by comparing the AAD initiated by the healthcare provider against guideline recommendations for first‐line treatment, given the presence of heart failure, coronary artery disease, both, or neither (as determined by International Classification of Diseases, Ninth Revision and Tenth Revision [ ICD‐9 and ICD‐10 ] codes). Concordance was also assessed by provider type using Medicare taxonomy codes. For the 15 445 patients included, 51% of healthcare providers initiated AAD treatments with amiodarone, 18% flecainide, 15% sotalol, 8% dronedarone, 5% propafenone, and 2% dofetilide. The overall rate of guideline concordance was 61%, with differences by provider type: 67% for electrophysiologists, 61% for cardiologists, and 60% for others (internal medicine, etc). Conclusions There continues to be a sizable gap in concordance between practice and guidelines in first‐line rhythm management of patients with atrial fibrillation. Further research is needed to identify possible explanations for non–guideline‐recommended use of AADs, in addition to enhanced AAD educational strategies for practitioners.

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Comparison of Adherence to the 2013 ACC/AHA Cholesterol Guideline in a Teaching Versus Nonteaching Outpatient Clinic

Cited by 3 publications

References 19 publications

Effect of pharmacist intervention on blood conservation therapy in total knee arthroplasty: A retrospective, observational study

Effect of pharmacist intervention on blood conservation therapy in total knee arthroplasty: A retrospective, observational study

Profile of use and access to statins in patients with coronary arterial disease in an outpatient clinic of a teaching hospital

US Antiarrhythmic Drug Treatment for Patients With Atrial Fibrillation: An Insurance Claims–Based Report

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