Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study

<h3>Background</h3><p dir="ltr">Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity in Qatar and globally.</p><h3>Aim</h3><p dir="ltr">The primary objective of the study was to evaluate the effectiveness of a struc...

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Main Author: Maguy Saffouh El Hajj (14151477) (author)
Other Authors: Rasha Kaddoura (12506936) (author), Safae E. A. Abu Yousef (17785676) (author), Bassant Orabi (17269123) (author), Ahmed Awaisu (5121473) (author), Sumaya AlYafei (17785679) (author), Rula Shami (14151504) (author), Ziyad R. Mahfoud (6103547) (author)
Published: 2023
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author Maguy Saffouh El Hajj (14151477)
author2 Rasha Kaddoura (12506936)
Safae E. A. Abu Yousef (17785676)
Bassant Orabi (17269123)
Ahmed Awaisu (5121473)
Sumaya AlYafei (17785679)
Rula Shami (14151504)
Ziyad R. Mahfoud (6103547)
author2_role author
author
author
author
author
author
author
author_facet Maguy Saffouh El Hajj (14151477)
Rasha Kaddoura (12506936)
Safae E. A. Abu Yousef (17785676)
Bassant Orabi (17269123)
Ahmed Awaisu (5121473)
Sumaya AlYafei (17785679)
Rula Shami (14151504)
Ziyad R. Mahfoud (6103547)
author_role author
dc.creator.none.fl_str_mv Maguy Saffouh El Hajj (14151477)
Rasha Kaddoura (12506936)
Safae E. A. Abu Yousef (17785676)
Bassant Orabi (17269123)
Ahmed Awaisu (5121473)
Sumaya AlYafei (17785679)
Rula Shami (14151504)
Ziyad R. Mahfoud (6103547)
dc.date.none.fl_str_mv 2023-02-16T03:00:00Z
dc.identifier.none.fl_str_mv 10.1007/s11096-023-01538-4
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Effectiveness_of_a_structured_pharmacist-delivered_intervention_for_patients_post-acute_coronary_syndromes_on_all-cause_hospitalizations_and_cardiac-related_hospital_readmissions_a_prospective_quasi-experimental_study/24995717
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Acute coronary syndrome
Hospitalization
Mortality
Patient discharge
Patient education
Pharmacist care
Qatar
dc.title.none.fl_str_mv Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity in Qatar and globally.</p><h3>Aim</h3><p dir="ltr">The primary objective of the study was to evaluate the effectiveness of a structured clinical pharmacist-delivered intervention on all-cause hospitalizations and cardiac-related readmissions in patients with ACS.</p><h3>Method</h3><p dir="ltr">A prospective quasi-experimental study was conducted at Heart Hospital in Qatar. Discharged ACS patients were allocated to one of three study arms: (1) an intervention group (received a structured clinical pharmacist-delivered medication reconciliation and counselling at discharge, and two follow-up sessions at 4 weeks and 8 weeks post-discharge), (2) a usual care group (received the general usual care at discharge by clinical pharmacists) or, (3) a control group (discharged during weekends or after clinical pharmacists' working hours). Follow-up sessions for the intervention group were designed to re-educate and counsel patients about their medications, remind them about the importance of medication adherence, and answer any questions they may have. At the hospital, patients were allocated into one of the three groups based on intrinsic and natural allocation procedures. Recruitment of patients took place between March 2016 and December 2017. Data were analyzed based on intention-to-treat principles.</p><h3>Results</h3><p dir="ltr">Three hundred seventy-three patients were enrolled in the study (intervention = 111, usual care = 120, control = 142). Unadjusted results showed that the odds of 6-month all-cause hospitalizations were significantly higher among the usual care (OR 2.034; 95% CI: 1.103–3.748, p = 0.023) and the control arms (OR 2.704; 95% CI: 1.456–5.022, p = 0.002) when compared to the intervention arm. Similarly, patients in the usual care arm (OR 2.304; 95% CI: 1.122–4.730, p = 0.023) and the control arm (OR 3.678; 95% CI: 1.802–7.506, p ≤ 0.001) had greater likelihood of cardiac-related readmissions at 6 months. After adjustment, these reductions were only significant for cardiac-related readmissions between control and intervention groups (OR 2.428; 95% CI: 1.116–5.282, p = 0.025).</p><h3>Conclusion</h3><p dir="ltr">This study demonstrated the impact of a structured intervention by clinical pharmacists on cardiac-related readmissions at 6 months post-discharge in patients post-ACS. The impact of the intervention on all-cause hospitalization was not significant after adjustment for potential confounders. Large cost‐effective studies are required to determine the sustained impact of structured clinical pharmacist-provided interventions in ACS setting.</p><h3>Trial registration</h3><p dir="ltr">Clinical Trials: NCT02648243 Registration date: January 7, 2016.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Clinical Pharmacy<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s11096-023-01538-4" target="_blank">https://dx.doi.org/10.1007/s11096-023-01538-4</a></p>
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identifier_str_mv 10.1007/s11096-023-01538-4
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/24995717
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spelling Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental studyMaguy Saffouh El Hajj (14151477)Rasha Kaddoura (12506936)Safae E. A. Abu Yousef (17785676)Bassant Orabi (17269123)Ahmed Awaisu (5121473)Sumaya AlYafei (17785679)Rula Shami (14151504)Ziyad R. Mahfoud (6103547)Biomedical and clinical sciencesCardiovascular medicine and haematologyPharmacology and pharmaceutical sciencesAcute coronary syndromeHospitalizationMortalityPatient dischargePatient educationPharmacist careQatar<h3>Background</h3><p dir="ltr">Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity in Qatar and globally.</p><h3>Aim</h3><p dir="ltr">The primary objective of the study was to evaluate the effectiveness of a structured clinical pharmacist-delivered intervention on all-cause hospitalizations and cardiac-related readmissions in patients with ACS.</p><h3>Method</h3><p dir="ltr">A prospective quasi-experimental study was conducted at Heart Hospital in Qatar. Discharged ACS patients were allocated to one of three study arms: (1) an intervention group (received a structured clinical pharmacist-delivered medication reconciliation and counselling at discharge, and two follow-up sessions at 4 weeks and 8 weeks post-discharge), (2) a usual care group (received the general usual care at discharge by clinical pharmacists) or, (3) a control group (discharged during weekends or after clinical pharmacists' working hours). Follow-up sessions for the intervention group were designed to re-educate and counsel patients about their medications, remind them about the importance of medication adherence, and answer any questions they may have. At the hospital, patients were allocated into one of the three groups based on intrinsic and natural allocation procedures. Recruitment of patients took place between March 2016 and December 2017. Data were analyzed based on intention-to-treat principles.</p><h3>Results</h3><p dir="ltr">Three hundred seventy-three patients were enrolled in the study (intervention = 111, usual care = 120, control = 142). Unadjusted results showed that the odds of 6-month all-cause hospitalizations were significantly higher among the usual care (OR 2.034; 95% CI: 1.103–3.748, p = 0.023) and the control arms (OR 2.704; 95% CI: 1.456–5.022, p = 0.002) when compared to the intervention arm. Similarly, patients in the usual care arm (OR 2.304; 95% CI: 1.122–4.730, p = 0.023) and the control arm (OR 3.678; 95% CI: 1.802–7.506, p ≤ 0.001) had greater likelihood of cardiac-related readmissions at 6 months. After adjustment, these reductions were only significant for cardiac-related readmissions between control and intervention groups (OR 2.428; 95% CI: 1.116–5.282, p = 0.025).</p><h3>Conclusion</h3><p dir="ltr">This study demonstrated the impact of a structured intervention by clinical pharmacists on cardiac-related readmissions at 6 months post-discharge in patients post-ACS. The impact of the intervention on all-cause hospitalization was not significant after adjustment for potential confounders. Large cost‐effective studies are required to determine the sustained impact of structured clinical pharmacist-provided interventions in ACS setting.</p><h3>Trial registration</h3><p dir="ltr">Clinical Trials: NCT02648243 Registration date: January 7, 2016.</p><h2>Other Information</h2><p dir="ltr">Published in: International Journal of Clinical Pharmacy<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s11096-023-01538-4" target="_blank">https://dx.doi.org/10.1007/s11096-023-01538-4</a></p>2023-02-16T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s11096-023-01538-4https://figshare.com/articles/journal_contribution/Effectiveness_of_a_structured_pharmacist-delivered_intervention_for_patients_post-acute_coronary_syndromes_on_all-cause_hospitalizations_and_cardiac-related_hospital_readmissions_a_prospective_quasi-experimental_study/24995717CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/249957172023-02-16T03:00:00Z
spellingShingle Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
Maguy Saffouh El Hajj (14151477)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Acute coronary syndrome
Hospitalization
Mortality
Patient discharge
Patient education
Pharmacist care
Qatar
status_str publishedVersion
title Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_full Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_fullStr Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_full_unstemmed Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_short Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
title_sort Effectiveness of a structured pharmacist-delivered intervention for patients post-acute coronary syndromes on all-cause hospitalizations and cardiac-related hospital readmissions: a prospective quasi-experimental study
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Acute coronary syndrome
Hospitalization
Mortality
Patient discharge
Patient education
Pharmacist care
Qatar