Advances in Cardiovascular Disease Management by Pharmacists

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (1 March 2024) | Viewed by 7310

Special Issue Editor


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Guest Editor
School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
Interests: cardiovascular pharmacotherapy; clinical outcomes; pharmacogenomics; implementation science

Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) is the leading cause of patient morbidity and mortality. Pharmacists are integral to the management of patients with CVD through team-based care, collaborative medication therapy management, prospective medication review and monitoring to optimize the therapy, screening and prevention of adverse reactions and drug interactions; manage cardiovascular risk factors; provide patient education; reconcile medication; provide medication information and decision support; and improve clinical outcomes. Within team-based care models, pharmacists serve an essential role as the medication experts who improve quality of care through cardiovascular (CV) pharmacotherapy optimization. Cardiovascular pharmacists also participate in protocol, guideline, and policy development; research; quality improvement; formulary management; and financial stewardship. This Special Issue invites original research and review articles addressing advances in pharmacists’ roles in the prevention and treatment of patients with CVD. This may include any of the following:

  • Innovative CV pharmacy practice models;
  • Observational studies;
  • Clinical trials in pharmacy settings, or involving pharmacists as part of the care team;
  • Expert opinion pieces on pharmacists’ roles in CVD;
  • Barriers and solutions to optimal implementation models of CV care;
  • Narrative reviews;
  • Systematic reviews;
  • Case studies.

Dr. James Coons
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular disease
  • clinical pharmacy
  • community pharmacy
  • pharmacists
  • cardiovascular pharmacotherapy
  • cardiology
  • team-based care

Published Papers (4 papers)

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Research

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12 pages, 879 KiB  
Article
The Prevalence and Impact of Evidence-Based Medications on Cardiovascular and Cerebrovascular Outcomes in Patients with Acute Coronary Syndrome Post-Revascularization in Oman
by Dalia Ahmed Al-Hadithy, Juhaina Salim Al-Maqbali, Adil Al-Riyami, Mohammed Al Za’abi and Ibrahim Al-Zakwani
Pharmacy 2023, 11(3), 79; https://doi.org/10.3390/pharmacy11030079 - 26 Apr 2023
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Abstract
Objectives: International cardiovascular guidelines recommend prescribing a combination of five evidence-based medications (EBM) for acute coronary syndrome (ACS) patients post-revascularization. This study aims to assess the prevalence and impact of prescribing the full (five medications) versus partial (four medications or fewer) EBM combination [...] Read more.
Objectives: International cardiovascular guidelines recommend prescribing a combination of five evidence-based medications (EBM) for acute coronary syndrome (ACS) patients post-revascularization. This study aims to assess the prevalence and impact of prescribing the full (five medications) versus partial (four medications or fewer) EBM combination on major adverse cardiovascular and cerebrovascular events (MACCE) in patients with ACS post-revascularization. Methods: Data from patients with ACS who had revascularization between January 2016 and September 2021 were collected retrospectively. Patients were then followed up until March 2022 for MACCE. Results: The full EBM combination was prescribed to 70% of the patients. However, after taking into account the presence of contraindications and clinical factors, the actual adherence to the guidelines was 95%. Patients who received the full EBM combination were younger (58 versus 62 years; p = 0.0 and 3) and had lower rates of chronic kidney disease (11% versus 41%; p < 0.001) and heart failure (9% versus 20%; p = 0.012) when compared to patients who received the partial EBM. Compared to the partial EBM group, the full EBM group was associated with lower MACCE rates (54% versus 37%, p = 0.012). After employing the propensity score technique utilizing the 1:1 nearest neighbor matching method without replacement, the univariate findings were further re-affirmed with those on full EBMs (compared to those on partial EBMs) associated with a significant reduction in the MACCE rate (average treatment effect of −25%; 95% confidence interval: −10–−40%; p = 0.001). Conclusions: The full EBM utilization was significantly high in our setting and in line with international guidelines. The full EBM combination was predominantly prescribed in younger and less comorbid patients and was associated with lower MACCE rates. The findings were further reaffirmed by the propensity score matching method. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Disease Management by Pharmacists)
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7 pages, 3466 KiB  
Communication
Analysis of Pharmacy Cardiac Optimization Clinic for Patients with New Onset Atrial Fibrillation Detected via Cardiac Implantable Electronic Device Clinic
by Ellen Schellhase, Madeline Stanko, Natalie Kinstler, Monica L. Miller, Sotiris Antoniou, Sadeer Fhadil, Mital Patel and Paul Wright
Pharmacy 2023, 11(2), 48; https://doi.org/10.3390/pharmacy11020048 - 03 Mar 2023
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Abstract
For patients with cardiac implantable electronic devices (CIEDs), arrythmias such as atrial fibrillation (AF) can be detected and actions taken to rapidly assess and initiate treatment where appropriate. Actions include timely initiation of anticoagulation, review of blood pressure, and optimization of cholesterol/lipids to [...] Read more.
For patients with cardiac implantable electronic devices (CIEDs), arrythmias such as atrial fibrillation (AF) can be detected and actions taken to rapidly assess and initiate treatment where appropriate. Actions include timely initiation of anticoagulation, review of blood pressure, and optimization of cholesterol/lipids to prevent unfavorable outcomes, such as stroke and other cardiovascular complications. Delays to initiating anticoagulation can have devastating consequences. We sought to implement a virtual clinic, where a pharmacist reviews patient referrals from a CIED clinic after detecting AF from the CIED. Anticoagulation choice is determined by patient-specific factors, and a shared patient–provider decision to start oral anticoagulation is made. In addition, blood pressure readings and medications are assessed with lipid-lowering therapies for optimization. A total of 315 patients have been admitted through this clinic and anticoagulated over a two-year span; in addition, 322 successful interventions were made for optimization of cardiac therapy. Rapid initiation of anticoagulation within five days of referral was likely to have reduced unfavorable outcomes, such as stroke and other cardiovascular optimizations, leading to improved patient outcomes. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Disease Management by Pharmacists)
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15 pages, 1519 KiB  
Article
Closing the Integration Gap: A Pilot for Incorporating Foundational Sciences, DEI-Decision Making, Empathy, and Communication for Congestive Heart Failure and Arrhythmia Management by Pharmacy Students
by Ashim Malhotra, Song Oh, Zhuqiu Jin and Xiaodong Feng
Pharmacy 2022, 10(4), 77; https://doi.org/10.3390/pharmacy10040077 - 01 Jul 2022
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Abstract
Pharmacists must integrate foundational sciences with pharmacy practice for providing optimal patient care. Pharmacy students need to be trained to provide culturally competent, linguistically accessible, and empathetic care while integrating foundational science principles. However, such holistic integration is challenging to achieve and assess. [...] Read more.
Pharmacists must integrate foundational sciences with pharmacy practice for providing optimal patient care. Pharmacy students need to be trained to provide culturally competent, linguistically accessible, and empathetic care while integrating foundational science principles. However, such holistic integration is challenging to achieve and assess. To bridge this gap, we implemented and assessed an “integrated cardiovascular simulation” (ICS) module for P2 students, employing case-based and team-based learning. ICS focused on congestive heart failure with preexisting arrhythmia and incorporated patient counseling relating to diversity factors such as cultural competency, linguistic challenges, and the impact of population diversity on cardiac diseases. Students learned the SBAR communication technique (situation, background, assessment, and recommendation) and recommended therapy while elaborating on drug MOA and adverse effects. ICS was assessed through pre-and post-session quizzes and perception data immediately after the activity, and after two years, when students progressed to the cardiovascular APPE block. Student performance improved on a post-test (80.2%) compared to the pre-test (66.9%), p < 0.01 paired student t-test, with an increase in symptom and arrhythmia pattern recognition (41.2% and 36.7%, respectively). ICS was effective for teaching (1) arrhythmia pathophysiology (85%), (2) EKG interpretation (89%), (3) drug adverse effects (93%), (4) DEI-clinical decision making (92%), and (5) communication skills (85%). Full article
(This article belongs to the Special Issue Advances in Cardiovascular Disease Management by Pharmacists)
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Review

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11 pages, 268 KiB  
Review
Management Considerations for Pulmonary Arterial Hypertension Pharmacotherapy in the Intensive Care Unit
by Elizabeth M. Foster, Danine Sullinger and James C. Coons
Pharmacy 2023, 11(5), 145; https://doi.org/10.3390/pharmacy11050145 - 13 Sep 2023
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Abstract
Pulmonary arterial hypertension is a rare and progressive disease with significant morbidity and mortality risk. Several medications targeting three major disease pathways are approved for treatment. However, the management of pulmonary arterial hypertension pharmacotherapies in a patient admitted to an intensive care unit [...] Read more.
Pulmonary arterial hypertension is a rare and progressive disease with significant morbidity and mortality risk. Several medications targeting three major disease pathways are approved for treatment. However, the management of pulmonary arterial hypertension pharmacotherapies in a patient admitted to an intensive care unit poses unique challenges. Factors such as intubation and altered mental status may prevent the continuation of home oral and/or inhaled therapy, and the progression of the disease may require escalation of therapy. This review will focus on practical management strategies for the continuation of home pulmonary arterial hypertension pharmacotherapy and escalation of therapy. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Disease Management by Pharmacists)
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