Current perspectives on the role of the pharmacist in heart failure management

Abstract

Pharmacists play an important role within a multidisciplinary health care team in the care of patients with heart failure (HF). It has been evaluated and documented that pharmacists providing medication reconciliation especially during transition of care, educating patients on their medications, and providing collaborative medication management lead to positive changes in the patient outcomes, including but not limited to decreasing in hospitalizations and read-missions. It is foreseeable that pharmacist roles will continue to expand as new treatment and innovative care are developed for HF patients. I reviewed published role of pharmacists in the care of HF patients. MEDLINE and Current Content database (both from 1966 – December 31, 2017) were utilized to identify peer-reviewed clinical trials, descriptive studies, and review articles published in English using the following search terms: pharmacists, clinical pharmacy, HF, and cardiomyopathy. Citations from available articles were also reviewed for additional references. Preliminary search revealed 31 studies and 55 reviews. They were further reviewed by title and abstract as well as full text to remove irrelevant articles. At the end, 24 of these clinical trials and systematic reviews are described in the following text and Table 1 summarizes 16 pertinent clinical trials. Some roles that are currently being explored include medication management in patients with mechanical circulatory support for end-stage HF, where pharmacokinetics and pharmacodynamics of medications can change, medication management in ambulatory intravenous diuretic clinics, and comprehensive medication management in patients’ home settings. Pharmacists should continue to explore and prospectively evaluate their role in the care of this patient population, including documenting their interventions, and impact to economic and patient outcomes.

The Excellence of Pharmacy Practice

“…It has been evaluated and documented that pharmacists providing medication reconciliation especially during transition of care, educating patients on their medications, and providing collaborative medication management lead to positive changes in the patient outcomes, including but not limited to decreasing in hospitalizations and re-admissions [91][92][93]. Through a combination of educational and organizational support, a general practice-based pharmacist led collaborative intervention can improve statin prescribing and achievement of cholesterol targets in a high-risk primary care-based population [94].…”

The Excellence of Pharmacy Service: Past, Present and Future

“…It has been evaluated and documented that pharmacists providing medication reconciliation especially during transition of care, educating patients on their medications, and providing collaborative medication management lead to positive changes in the patient outcomes, including but not limited to decreasing in hospitalizations and re-admissions [91][92][93]. Through a combination of educational and organizational support, a general practice-based pharmacist led collaborative intervention can improve statin prescribing and achievement of cholesterol targets in a highrisk primary care-based population [94].…”

Impact of Pharmacist Involvement in Heart Failure Transition of Care

“…5 Medication reconciliation is defined as a process of comparing patient’s medication orders to all the medications that the patient has been taking to avoid medication errors such as omission, duplications, dosing errors, and interactions. 6…”

“…5 Medication reconciliation is defined as a process of comparing patient's medication orders to all the medications that the patient has been taking to avoid medication errors such as omission, duplications, dosing errors, and interactions. 6 There have been several studies that assessed the impact of pharmacist-led TOC programs. One TOC program at a 390-bed community teaching hospital involving a pharmacist, resident, student, and HF nurse navigator performed admission medication review, discharge medication review, and discharge counseling.…”