International journal of clinical pharmacy · 2021
Physician-pharmacist collaborative management in patients after percutaneous coronary intervention: a retrospective propensity score matching cohort study.
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Zhang Qingxia, Su Haofan, Li Boyu, Bai Xiangrong, Yan Suying, Li Xiaoling
Аннотация
AIM: Evaluate the effect of the Physician-Pharmacist Collaborative Management (PPCM) practice model in patients after percutaneous coronary intervention (PCI).
METHOD: A retrospective cohort study was conducted in post-PCI patients. The study enrolled patients who underwent PCI at our hospital from May 1, 2018, to January 31, 2020. Patients were divided into two groups: the PPCM group if they utilized the Complex Coronary Interventions Medication Therapy Management (CCI-MTM) clinic and the usual care (UC) group if they used the physician-only cardiology clinic. Patients had clinic visits monthly, and data were analyzed after 6-months of follow-up. A propensity score matching (PSM) method was used to control confounding bias between groups.
RESULTS: A total of 727 patients met the inclusion criteria, including 67 patients in the PPCM group and 660 patients in the UC group. Using the 1:2 nearest neighbor matching method, 61 pairs were successfully matched; this included 61 patients in the PPCM group and 122 patients in the UC group. The proportion of patients reaching both LDL-C (73.8% versus 41.0%, P < 0.001) and heart rate (14.8% versus 4.1%, P = 0.007) goals in the PPCM was higher compared to the UC group. The median time to achieving the goal LDL-C was shorter in the PPCM group (31 days versus 126 days, P = 0.001). The utilization rates of [Formula: see text]-receptor blockers (73.8% versus 56.6%, P = 0.005) and ACEIs or ARBs (72.1% versus 56.6%, P = 0.018) were higher in the PPCM group compared to the UC group. There was no significant difference in adverse drug events between the two groups (P > 0.05). All recommendations to resolve drug-related problems were accepted by the physicians and patients.
CONCLUSION: The pharmaceutical care provided by the pharmacist in the PPCM clinic improved risk factor control and increased the utilization of preventive drugs in post-PCI patients.
METHOD: A retrospective cohort study was conducted in post-PCI patients. The study enrolled patients who underwent PCI at our hospital from May 1, 2018, to January 31, 2020. Patients were divided into two groups: the PPCM group if they utilized the Complex Coronary Interventions Medication Therapy Management (CCI-MTM) clinic and the usual care (UC) group if they used the physician-only cardiology clinic. Patients had clinic visits monthly, and data were analyzed after 6-months of follow-up. A propensity score matching (PSM) method was used to control confounding bias between groups.
RESULTS: A total of 727 patients met the inclusion criteria, including 67 patients in the PPCM group and 660 patients in the UC group. Using the 1:2 nearest neighbor matching method, 61 pairs were successfully matched; this included 61 patients in the PPCM group and 122 patients in the UC group. The proportion of patients reaching both LDL-C (73.8% versus 41.0%, P < 0.001) and heart rate (14.8% versus 4.1%, P = 0.007) goals in the PPCM was higher compared to the UC group. The median time to achieving the goal LDL-C was shorter in the PPCM group (31 days versus 126 days, P = 0.001). The utilization rates of [Formula: see text]-receptor blockers (73.8% versus 56.6%, P = 0.005) and ACEIs or ARBs (72.1% versus 56.6%, P = 0.018) were higher in the PPCM group compared to the UC group. There was no significant difference in adverse drug events between the two groups (P > 0.05). All recommendations to resolve drug-related problems were accepted by the physicians and patients.
CONCLUSION: The pharmaceutical care provided by the pharmacist in the PPCM clinic improved risk factor control and increased the utilization of preventive drugs in post-PCI patients.