Physician-pharmacist collaborative management in patients after percutaneous coronary intervention: a retrospective propensity score matching cohort study
机构:[1]Department of Pharmacy, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Disease, Beijing, China 首都医科大学宣武医院[2]Department of Pharmacy, Beijing Ditan Hospital, Capital Medical University, Beijing, China [3]Department of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China内科系统心脏科(内科专业)首都医科大学宣武医院
Aim: Evaluate the effect of the Physician-Pharmacist Collaborative Management (PPCM) practice model in patients after percutaneous coronary intervention (PCI). Method: A retrospective cohort study was conducted in post-PCI patients. The study enrolled patients who underwent PCI at our hospital from May 1, 2018, to January 31, 2020. Patients were divided into two groups: the PPCM group if they utilized the Complex Coronary Interventions Medication Therapy Management (CCI-MTM) clinic and the usual care (UC) group if they used the physician-only cardiology clinic. Patients had clinic visits monthly, and data were analyzed after 6-months of follow-up. A propensity score matching (PSM) method was used to control confounding bias between groups. Results: A total of 727 patients met the inclusion criteria, including 67 patients in the PPCM group and 660 patients in the UC group. Using the 1:2 nearest neighbor matching method, 61 pairs were successfully matched; this included 61 patients in the PPCM group and 122 patients in the UC group. The proportion of patients reaching both LDL-C (73.8% versus 41.0%, P < 0.001) and heart rate (14.8% versus 4.1%, P = 0.007) goals in the PPCM was higher compared to the UC group. The median time to achieving the goal LDL-C was shorter in the PPCM group (31 days versus 126 days, P = 0.001). The utilization rates of beta-receptor blockers (73.8% versus 56.6%, P = 0.005) and ACEIs or ARBs (72.1% versus 56.6%, P = 0.018) were higher in the PPCM group compared to the UC group. There was no significant difference in adverse drug events between the two groups (P > 0.05). All recommendations to resolve drug-related problems were accepted by the physicians and patients. Conclusion: The pharmaceutical care provided by the pharmacist in the PPCM clinic improved risk factor control and increased the utilization of preventive drugs in post-PCI patients.
基金:
National Key R&D Program of
China (2020YFC2008305) and Beijing Science and Technology Commission—
Research on Key Technologies of Health Assessment and
Maintenance for the Elderly in Beijing (D181100000218002).