Underutilization of cardiovascular medications: Effect of a continuity-of-care program

Emily N ISRAEL; T. Michael FARLEY; Karen B FARRIS; Barry L CARTER

doi:10.2146/ajhp120786

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Underutilization of cardiovascular medications: Effect of a continuity-of-care program

Journal article

Open access

Peer reviewed

Underutilization of cardiovascular medications: Effect of a continuity-of-care program

Emily N ISRAEL, T. Michael FARLEY, Karen B FARRIS and Barry L CARTER

American journal of health-system pharmacy, Vol.70(18), pp.1592-1600

2013

DOI: 10.2146/ajhp120786

PMCID: PMC4019344

PMID: 23988600

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Abstract

Purpose The effect of hospital pharmacists’ enhanced communication with patients and community providers on the underutilization of key cardiovascular medications was studied. Methods Patients enrolled in the Iowa Continuity of Care study were eligible for inclusion in this study if they had a diagnosis of hypertension, hyperlipidemia, heart failure, coronary artery disease, or a combination of these diagnoses. Eligible patients also had to be admitted to the internal medicine, family medicine, cardiology, or orthopedics services and receive their usual medical care in the community and their prescriptions from a community pharmacy. Patients were randomized to receive minimal intervention, enhanced intervention, or usual care. For the minimal- and enhanced-intervention groups, pharmacy case managers (PCMs) performed comprehensive medication reconciliations and identified drug-related problems within 24 hours of admission. The PCMs made recommendations to the inpatient care team and to patients’ community physicians. For patients in the enhanced-intervention group, the PCM developed a discharge care plan containing the patient’s discharge medication list. PCMs made specific recommendations to optimize regimens that did not meet current guidelines or medications that were underutilized. Medication underutilization was assessed at admission, discharge, 30 days after discharge, and 90 days after discharge. Results A total of 732 patients were enrolled in this study. There were no significant differences among the three study groups. Overall, the rate of underutilization remained constant among all three groups, despite enhanced pharmacist involvement in both intervention groups. Conclusion Enhanced interventions by PCMs had no effect on the underutilization of key cardiovascular drugs during hospitalization or after hospital discharge.

Public health. Hygiene-occupational medicine

Public health. Hygiene

Health participants

General pharmacology

Pharmacology. Drug treatments

Biological and medical sciences

Medical sciences

Clinical trial. Drug monitoring

Details

Title: Subtitle: Underutilization of cardiovascular medications: Effect of a continuity-of-care program
Creators: Emily N ISRAEL - Practice Resident, University of Michigan Health System, Ann Arbor., United States
T. Michael FARLEY - Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City, United States
Karen B FARRIS - College of Pharmacy, University of Michigan, Ann Arbor, United States
Barry L CARTER - Department of Pharmacy Practice and Science, College of Pharmacy, United States
Resource Type: Journal article
Publication Details: American journal of health-system pharmacy, Vol.70(18), pp.1592-1600
DOI: 10.2146/ajhp120786
PMID: 23988600
PMCID: PMC4019344
NLM abbreviation: Am J Health Syst Pharm
ISSN: 1079-2082
eISSN: 1535-2900
Publisher: American Society of Health Pharmacists; Bethesda, MD
Language: English
Date published: 2013
Academic Unit: Pharmacy Practice and Science
Record Identifier: 9984065318802771

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