Outcomes in heart failure patients can be improved by the addition of a pharmacist to a multidisciplinary heart failure team, researchers say. The effect of pharmacists may result in patients taking higher doses of angiotensin converting enzyme (ACE) inhibitors or receiving closer follow up, report Ms Wendy Gattis (pharmacist, division of cardiology, Duke University medical centre, US) and colleagues.
In a study of 181 outpatients, they found that pharmacist intervention resulted in a reduction in events (non-fatal heart failure events and all cause mortality) after a median follow up of six months.
Patients in the intervention group were closer to target ACE inhibitor dose at follow up at six months than those in the control group.
The authors comment that a typical patient with heart failure is likely to be taking several different drugs, increasing the risk of interactions and toxic effects. A clinical pharmacist can review drug regimes, assist in the selection of drugs and may monitor therapy, they say. Pharmacists can also educate patients about medication adherence (Archives of Internal Medicine 1999;159:1939).