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. 2019 Sep;26(5):248-252.
doi: 10.1136/ejhpharm-2017-001344. Epub 2018 Mar 14.

Clinical pharmacist intervention reduces mortality in patients with acute myocardial infarction: a propensity score matched analysis

Xiao-Bo Zhai #  1 , Zhi-Chun Gu #  2 , Xiao-Yan Liu  2
Affiliations

Clinical pharmacist intervention reduces mortality in patients with acute myocardial infarction: a propensity score matched analysis

Xiao-Bo Zhai et al. Eur J Hosp Pharm. 2019 Sep.

Abstract

Background: Is it possible that the mortality rate from acute myocardial infarction (AMI) may decline after interventions by pharmacists?

Objective: To evaluate the impact of clinical pharmacist on the mortality of AMI.

Methods: Clinical pharmacists did not perform any interventions during phase 1 (pre-intervention), and consulted with physicians to address drug related problems (DRPs) during phase 2 (post-intervention). The main outcome was a decrease in mortality from AMI. The two phases were compared using propensity score matching (PSM).

Results: 1388 interventions were suggested by clinical pharmacists during phase 2, of which 1239 (89.2%) were accepted. Logistic regression analysis demonstrated that interventions of clinical pharmacists were significantly associated with a reduced mortality in patients with both ST segment elevation myocardial infarction (STEMI) (OR 0.449; 95% CI 0.296 to 0.680) and non-ST segment elevation myocardial infarction (NSTEMI) (OR 0.268; 95% CI 0.125 to 0.572). Using PSM analysis, mortality reduced from 6.8% to 4.3% in STEMI patients (P=0.0034) and from 3.2% to 0.7% in NSTEMI patients (P=0.0202) after the interventions.

Conclusions: DRPs that caused or contributed to possible mortality were detected by clinical pharmacists in patients with AMI. Correcting these DRPs after pharmacists' interventions could result in a significant decrease in mortality.

Keywords: acute myocardial infarction; clinical pharmacists; intervention; mortality; propensity score matching.

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Conflict of interest statement

Competing interests: None declared.

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