Published: Jun 26, 2020
  
 
     
 
Keywords:
role of pharmacist, drug use evaluation, drug related problems (DRPs), guideline adherence indicator (GAI), heart failure with reduced ejection fraction (HFrEF), multidisciplinary team
  
     
 
   
 
 
 
 
 
 
 
 
 
 
 

 

 
   
 
 
 
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    Home / Archives / Vol. 16 No. 1 (2020): ่January-Jane / Research Article  
 
   
 

ROLE OF PHARMACIST IN DRUG USE EVALUATION
FOR PATIENTS WITH HEART FAILURE
   
 
   
   
     
 
Plernta Sirimanuwat
Pharmacy Department, Taksin Hospital, Bangkok Metropolitan Administration
Usasiri Srisakul
Faculty of Pharmacy, Siam University
Warawut Umpornwirojkit
Heart Failure Clinic, Taksin Hospital, Bangkok Metropolitan Administration
Supaporn Pattanasan
Heart Failure Clinic, Taksin Hospital, Bangkok Metropolitan Administration
Apichot So-Ngern
เภสัชกรชำนาญการพิเศษ (ด้านเภสัชกรรมคลินิก) โรงพยาบาลตากสิน สำนักการแพทย์ กรุงเทพมหานคร

Abstract

Objective: The purposes of this research were to evaluate medications treatment with guideline adherence indicator (GAI) and evaluate drug related problems (DRPs) in patients with heart failure.


Materials and Methods: This is a study of retrospective analysis of quasi-experimental data in patient with heart failure with reduced ejection fraction (HFrEF) and received care by multidisciplinary team, follow-up from 1 October 2015 to 30 September 2017. Data collection included history of heart failure and underlying diseases, laboratory data, medication history, pharmacist records of DRPs management. Data was gathered and analyzed for evaluating and comparing guideline adherence indicator (GAI) and DRPs management reports.


Result:  A total of 97 patients had a mean age of 63.04 + 13.26 years old. There were male in 58.8 percent. The common comorbid diseases were myocardial infarction (82.47%), hypertension (78.4%), type 2 diabetes mellitus (49.50%), chronic kidney disease (40.21%), and atrial fibrillation (22.7%). After receiving the multidisciplinary team care, the completed-GAI (all 3 medications) found in 83 patients (85.6%) which increased significantly (p<0.001). There was a total of 401 DRPs recorded. The major DRPs included non-compliance (38.4%), dosage too low (23.7%), and adverse drug events (20.2%). Pharmacists managed by providing patient counseling with medication adjustment by cardiologists (53.6%), giving patient counseling (42.6%), and notifying cardiologists for correction of the prescriptions (3.0%). After DRPs monitoring, almost the DRPs were solved completely (86.03%). Moreover, the medications caused DRPs were 43.27 percent from heart failure treatment and 56.73 percent from medications for comorbid diseases.


Conclusions: Pharmacists have an important role in drug use evaluation for increasing rational drug use according to standard treatment guidelines. By providing DRPs management with identifying, solving, and monitoring DRPs, which was not limited to heart failure treatment but included all medications treated for underlying conditions. Therefore, patients will be received medication treatment effectively and safely.           

  
     
     
 
    How to Cite  
     
  Sirimanuwat, P., Srisakul, U., Umpornwirojkit , W., Pattanasan, S., & So-Ngern , A. (2020). ROLE OF PHARMACIST IN DRUG USE EVALUATION FOR PATIENTS WITH HEART FAILURE. Journal of Charoenkrung Pracharak Hospital, 16(1), 25–45. Retrieved from https://he02.tci-thaijo.org/index.php/JCP/article/view/237885  
     

 
 
     
     
 
    Issue  
     
  Vol. 16 No. 1 (2020): ่January-Jane  

 
 
     
     
 
    Section  
     
  Research  article  

 
 
     
     
     
 

References

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Executive summary: heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014; 129:399–410.

สำนักนโยบายและยุทธศาสตร์ สำนักงานปลัดกระทรวงสาธารณสุข. สถิติสาธารณสุข 2558 (Public health statistics A.D.2015). [อินเทอร์เน็ต]. 2559 [เข้าถึงเมื่อ 30 มกราคม 2560]. เข้าถึงได้จาก: https://bps.moph.go.th/new_bps

Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. New Engl J Med. 2009; 360:1418–28.

Barasa A, Schaufelberger M, Lappas G, Swedberg K, Dellborg M, Rosengren A. Heart failure in young adults: 20-year trends in hospitalization, aetiology, and case fatality in Sweden. Eur Heart J. 2014;

:25–32.

Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, et al. Long-term trends in the incidence of and survival with heart failure. New Engl J Med. 2002; 347:1397–402.

Roger VL, Weston SA, Redfield MM, Hellermann-Homan JP, Killian J, Yawn BP, et al. Trends in heart failure incidence and survival in a community-based population. JAMA. 2004; 292:344–50.

สมาคมแพทย์โรคหัวใจแห่งประเทศไทยในพระบรมราชูปถัมภ์. แนวทางเวชปฏิบัติเพื่อการวินิจฉัยและ

การดูแลรักษาผู้ป่วยภาวะหัวใจล้มเหลว พ.ศ. 2557. พิมพ์ครั้งที่ 1. กรุงเทพฯ: เอ-พลัส พริ้น; 2557.

Fonarow GC, Yancy CW, Hernandez AF, Peterson ED, Spertus JA, Heidenreich PA, et al. Potential impact of optimal implementation of evidence-based heart failure therapies on mortality. Am Heart J. 2011; 161:1024–30.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Colvin MM, et al. 2017 ACC/AHA/HFSA Focused update of the 2013 ACCF/AHA guideline for the management of heart failure. J Am Coll Cardiol 2017; 8:776-803.

Ponikowski P, Anker SD, Coats AJ, Falk V, Jankowska EA , Jessup M, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Hear J. 2016; 37(27):2129-200.

สำนักงานคณะกรรมการอาหารและยา. โครงการโรงพยาบาลส่งเสริมการใช้ยาอย่างสมเหตุผล. [อินเทอร์เน็ต]. 2558 [เข้าถึงเมื่อ 30 พฤษภาคม 2560]. เข้าถึงได้จาก: https://drug.fda.moph.go.th

Smith WE. Role of a pharmacist in improving rational drug therapy as part of the patient care team. Ann Pharmacother 2007;2(41):330-5.

Dempsey JT, Matta LS, Carter DM, Stevens CA, Stevenson LW, Desai AS, et al. Assessment of Drug Therapy-Related Issues in an Outpatient Heart Failure Population and the Potential Impact of Pharmacist-Driven Intervention. J Pharm Pract 2017; 30(3):318-323.

Kanoksilp A, Hengrussamee K and Wuthiwaropas P. A Comparison of One- Year Outcome in Adult Patients with Heart Failure in Two Medical Setting: Heart Failure Clinic and Daily Physician Practice.

J Med Assoc Thai. 2009; 92(4):466-470.

Komajda M, Lapuerta P, Hermans N, Gonzalez-Juanatey JR, van Veldhuisen DJ, Erdmann E, et al. Adherence to guidelines is a predictor of outcome in chronic heart failure: the MAHLER survey. Eur Heart J 2005;26:1653–9.

Stork S, Hense HW, Zentgraf C, Uebelacker I, Jahns R, Ertlet G, et al. Pharmacotherapy according to treatment guidelines is associated with lower mortality in a community-based sample of patients with chronic heart failure: a prospective cohort study. Eur J Heart Fail 2008; 10:1236–45.

Poelzl G, Altenberger J, Pacher R, Ebner CH, Wieser M, Winter A, et al. Dose matters! Optimisation of guideline adherence is associated with lower mortality in stable patients with chronic heart failure. Int J Cardiol. 2014 Jul 15;175(1):83-9.

Frankenstein L, Remppis A, Fluegel A, Doesch A, Katus HA, Senges J, et al. The association between long-term longitudinal trends in guideline adherence and mortality in relation to age and sex. Eur J Heart Fail 2010; 12:574–80.

Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam G. Drug related problem: their structure and function. DICP Pharmacother 1990; 24:1093-7.

American Society of Health-System Pharmacists. ASHP statement on pharmaceutical care. Am J Hosp Pharm 1993; 50:1720-3.

Pharmaceutical Care Network Europe (PCNE). Classification for drug related problems V 8.01. 2017 [internet]. 2017 [cited 2017 June 30]. Available from: https://www.pcne.org/working-groups/2/drug-related-problem-classification

สิทธิลักษณ์ วงษ์วันทนีย์, สำอางค์ เกียรติเจริญสิน, ปราณี ดาวมณี, ชลลดา จรัสพัฒนวงษ์, และทักษิณา กัมติ. การดูแลแบบสหสาขาวิชาชีพในคลินิกโรคหัวใจล้มเหลวโรงพยาบาลระยอง.วารสารศูนย์การศึกษาแพทยศาสตร์คลินิก โรงพยาบาลพระปกเกล้า. 2553; 27(4):222-233.

Murray MD, Young J, Hoke S, Tu W, Weiner M, Morrow D, et al. Pharmacist intervention to improve medication adherence in heart failure. Ann Intern Med. 2007; 146:714-725.

Davis EM, Packard KA, and Jackevicius CA. The Pharmacist Role in predicting and improving medication adherence in heart failure patients. J Manag Care Pharm. 2014; 20(7):741-55.

Hsu WT, Shen LJ, and Lee CM. Drug-related problems vary with medication category and treatment duration inTaiwanese heart failure outpatients receiving case management. J Formos Med Assoc. 2016;115(5):335-42.

Lowrie R, Mair FS, Greenlaw N, Forsyth P,Jhund PS, McConnachie A, et al. Pharmacist intervention in primary care to improve outcomes in patients with left ventricular systolic dysfunction. European Heart Journal (2012) 33, 314–324.

Koshman SL, Charrois TL, Simpson SH, McAlister FA, Tsuyuki RT. Pharmacist care of patients with heart failure: asystematic review of randomized trials. Arch Intern Med. 2008;168(7):687-694.