Authors (including presenting author) :
Chung UQ(1), Goh ZH(1), Cheung MH(1), Leung YS(1), Wong KM(1), Wong PYJ(1), Wong CY(2), Cheung CYS(2), Li YC(3), Ho KM(3), Cheung YT(4)
Affiliation :
(1)Department of Pharmacy, Queen Elizabeth Hospital, (2)Department of Medicine, Queen Elizabeth Hospital, (3)Department of Family Medicine & Primary Healthcare, Kowloon Central Cluster, (4)School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong
Introduction :
An Integrated Pharmacist Cardiovascular Clinic (PCVC) has been established in a major public hospital and a general outpatient clinic in Hong Kong to improve patient care in hypertension, dyslipidaemia and overall cardiovascular risk control.
Objectives :
This study aimed to evaluate the impact of the PCVC on patients’ blood pressure and low-density lipoprotein cholesterol (LDL-C) control and to analyse medication interventions made by pharmacists.
Methodology :
In this retrospective cohort study, patients enrolled in the PCVC from October 2023 to March 2024 were compared with patients under usual care from October 2022 to March 2023. Primary outcomes were the mean changes in office systolic blood pressure (SBP) and LDL-C at month 6. Secondary outcomes were the proportion of patients attaining target LDL-C, frequency and types of pharmacists’ medication interventions and their acceptance by physicians, and summary of adverse drug reactions (ADRs) of antihypertensive and lipid-lowering agents reported within the study period.
Result & Outcome :
152 patients (mean age 70.7 years), including 76 who received care from the PCVC, were evaluated. After 6 months, significant differences (p <0.001) were observed in the mean changes (95% confidence interval) in office SBP and LDL-C in the PCVC group [-16.9 mmHg (-35.2, 1.4) and -0.73 mmol/L (-1.64, 0.18)] versus the control group [-2.5 mmHg (-18.3, 13.3) and +0.19 mmol/L (-0.49, 0.87)]. This was accompanied by a significant difference (p <0.001) in the proportion of patients attaining target LDL-C in the PCVC group (65.8%) versus the control group (38.2%). 131 medication interventions were made by pharmacists, including 77 dose escalations, 16 drug initiations and 11 changes in dosing frequency. All interventions were accepted by physicians. Nearly all ADRs reported are common side effects of the respective agents. In conclusion, pharmacists play an instrumental role in titrating and monitoring blood pressure- and lipid-lowering therapies, thereby improving proximal outcomes of cardiovascular diseases.
