Pharmacy-based interdisciplinary intervention for patients with chronic heart failure: results of the PHARM-CHF randomized controlled trial

79Citations
Citations of this article
175Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Aims: Medication non-adherence is frequent and is associated with high morbidity and mortality in patients with chronic heart failure (CHF). We investigated whether an interdisciplinary intervention improves adherence in elderly CHF patients. Methods and results: The study population (mean age 74 years, 62% male, mean left ventricular ejection fraction 47%, 52% in New York Heart Association class III) consisted of 110 patients randomized into the pharmacy care and 127 into the usual care group. The median follow-up was 2.0 years (interquartile range 1.2–2.7). The pharmacy care group received a medication review followed by regular dose dispensing and counselling. Control patients received usual care. The primary endpoint was medication adherence as proportion of days covered (PDC) within 365 days for three classes of heart failure medications (beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and mineralocorticoid receptor antagonists). The main secondary outcome was the proportion of adherent patients (PDC ≥ 80%). The primary safety endpoint was days lost due to unplanned cardiovascular hospitalizations (blindly adjudicated) or death. Pharmacy care compared with usual care resulted in an absolute increase in mean adherence to three heart failure medications for 365 days [adjusted difference 5.7%, 95% confidence interval (CI) 1.6–9.8, P = 0.007]. The proportion of patients classified as adherent increased (odds ratio 2.9, 95% CI 1.4–5.9, P = 0.005). Pharmacy care improved quality of life after 2 years (adjusted difference in Minnesota Living with Heart Failure Questionnaire scores −7.8 points (−14.5 to −1.1; P = 0.02), compared to usual care. Pharmacy care did not affect the safety endpoints of hospitalizations or deaths. Conclusion: Pharmacy care safely improved adherence to heart failure medications and quality of life.

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Schulz, M., Griese-Mammen, N., Anker, S. D., Koehler, F., Ihle, P., Ruckes, C., … Wachter, R. (2019). Pharmacy-based interdisciplinary intervention for patients with chronic heart failure: results of the PHARM-CHF randomized controlled trial. European Journal of Heart Failure, 21(8), 1012–1021. https://doi.org/10.1002/ejhf.1503

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 49

69%

Lecturer / Post doc 9

13%

Researcher 8

11%

Professor / Associate Prof. 5

7%

Readers' Discipline

Tooltip

Pharmacology, Toxicology and Pharmaceut... 23

33%

Medicine and Dentistry 21

30%

Nursing and Health Professions 20

29%

Psychology 6

9%

Article Metrics

Tooltip
Mentions
News Mentions: 2
Social Media
Shares, Likes & Comments: 262

Save time finding and organizing research with Mendeley

Sign up for free