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    Pharmacists on the Front Line in Treating Cardiac Disease

    Pharmacists in all practice settings can make a difference.

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    Pharmacists spend time at each patient’s bedside prior to discharge to ensure that the patient understands their medication regimen. Mary Curtis, PharmD, is assigned to the cardiac unit. “We educate the patient on their medications and potential side effects,” she says. Our goal is to send the patient home on appropriate therapy and lower our readmission rates.”

    Pharmacists also “meet” with patients via FaceTime at Parham Doctors’ Hospital, also in Richmond.

    The program is expanding to include a pharmacist’s intervention up to the patient’s first postdischarge physician visit. The pilot program, which is focusing on high-risk patients, started in January. The emphasis,  says Curtis, is on chronic care management. “By the time the patient goes back to the doctor, we will have provided the physician with a postdischarge medication reconciliation, and other pertinent information,” Curtis says. This gives the cardiologist a heads-up on what to expect before the patient arrives for their appointment.

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    After that first physician visit, the patient is welcome to continue having their prescriptions filled at Bremo, if they choose Curtis says.

    Curtis explains that the Bremo pharmacists do not work within a collaborative drug therapy agreement, but feels that pharmacists and physicians have a strong relationship. “The physician can open the door to help the patient accept the pharmacist as a member of the health-care team,” she says. 

    Community Pharmacy

    Community pharmacists are making a difference as well, says Tomaka. Many community pharmacists provide blood pressure screenings, as well as counsel patients on lifestyle issues, such as diet and exercise. Others have smoking cessation programs.

    Tomaka cites an example from his own experience as a community pharmacist when he encouraged a patient to have a blood pressure reading in the pharmacy. It was determined that the patient was having an adverse reaction to a new medication, and the proper adjustment was made. In another instance, a patient was encouraged to take a blood pressure medication at a different time of day to avoid a side effect that was affecting quality of life.

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    The community pharmacist is in a good position to counsel patients on lifestyle issues, Tomaka says. A good resource for the pharmacist is the American Heart Association’s Diet and Lifestyle Recommendations.

    At Kaiser, Todd agrees that lifestyle issues are important. “We do focus quite a bit on therapies since we are pharmacists, but with each call (or at least we try), we talk about lifestyle. This includes a heart-healthy diet, weight loss, and exercise,” she says. “A unique part of what we do is allow time with patients to really get into the why. Many patients with ASCVD are told to take meds, lose weight, etc. This is overwhelming and they are never taught why it is so important. We are able to develop relationships with these patients since we follow them long-term,” she says.

    Curtis agrees. “It’s important for a patient to understand their meds, as well as to understand why lifestyle issues, such as diet and exercise are important. As a pharmacist, to give guidance to a patient, and to come to the point where you see that patient feeling better, is very rewarding.”

    Reference

    1. Zhai X, Gu Z, Liu X. Effectiveness of the clinical pharmacist in reducing mortality in hospitalized cardiac patients: a propensity score-matched analysis. Ther Clin Risk Manag. 2016;12:241-250.

    Kathleen Gannon Longo
    Kathleen Gannon Longo is a Contributing Editor.

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