Stewart S, Marley JE, Horowitz JD. Effects of a multidisciplinary, home-based intervention on planned readmissions and survival among patients with chronic congestive heart failure: a randomised controlled study. Lancet 1999;354:1077-83.
[Medline reference]
Gattis WA, Whellan DJ, O'Conner CM. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team. Arch Intern Med 1999;159:1939-45.
[Medline reference]
I have put these two papers together because, firstly the Lancet paper suggests that home based intervention after hospital discharge has the potential to decrease further admission and improve quality of life in this group of patients. This may be as a result of improved efficacy from the medication. The second paper confirms the pharmacist's role in improving patient outcome as a result of medication evaluation, patient education, optimisation of the dose of ACE- inhibitor and follow up after discharge. My own experience leads me to believe that ACE-inhibitor therapy initiated in primary care is often sub-optimal and even patients discharged from hospital need review and dosage adjustment after a period of time - another potential area for pharmacists to improve health gain?
What's in the medical press? - The rapidly changing situation in primary care means that it is often difficult to keep up to date with what is happening politically and clinically. This section of Primary Care Pharmacy will try to pick out a few articles that may be useful in day-to-day practice or have importance for the primary care role.