The Pharmaceutical Journal
Vol 268 No 7200 p777
1 June 2002

This article
Reprint
Photocopy

United Kingdom Clinical Pharmacy Association summary

Medicines management in CHD

Involving a pharmacist in a secondary prevention coronary heart disease clinic has an impact on clinical practice, said Val Reilly, primary care pharmacist, Burnbank medical centre, Blantyre and Hamilton Local Health Care Co-operative. A pharmacist's input is beneficial both clinically and economically.

Such a clinic has been implemented by a practice pharmacist and a senior practice nurse at Burnbank Medical Centre. Mrs Reilly, describing work that won the Pharmacia pharmacoeconomics award 2002, said that from September 1999 to February this year, 212 patients with established CHD were identified and included for review at the clinic.

Patients attended a 10-minute clerking visit, during which blood samples were taken and other relevant clinical parameters noted. Two weeks later they attended a 30-minute review visit with both the CHD nurse and practice pharmacist. At this second visit, blood test results were discussed and medication history confirmed. A pharmaceutical assessment was carried out and recommendations for changes to medication were submitted to a GP for approval. Relevant life style advice was also given.

From the start of the clinic until February 2002, the percentage of patients taking aspirin 75mg increased from 39 per cent to 92 per cent and the percentage of patients with angina receiving beta blockers increased from 24 per cent to 50 per cent. In 47 per cent of patients, statin therapy was initiated, reinitiated because of non-compliance or titrated up to a therapeutic dose. The annual spend on statins increased by £48,000, from £60,000 to £108,000. However, other annual drug cost savings of £38,000 were made to offset this, she said.

The inclusion of a pharmacist also highlighted issues such as the use of non-prescription medicines. The CHD nurse's confidence in recommending changes to therapy increased with support from the pharmacist, Mrs Reilly commented.