Pharmacist-led Care in Collaboration with a Cardiovascular Team to Improve the Management of Atherosclerotic Cardiovascular Disease Risk in Hospitalized Patients

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Background: Cardiovascular disease (CVD) is the leading cause of death worldwide, affecting approximately 17.5 million people yearly. In high-risk patients, reducing lipids, decreasing blood pressure, and ceasing smoking have been shown to lower primary and secondary CVD risk. This project aims to evaluate the impact of pharmacist-led care by identifying and managing atherosclerotic cardiovascular disease risk and further optimizing guideline-directed medical treatment (GDMT) in hospitalized patients with coronary artery disease (CAD). Methods: This biphasic quality improvement project was conducted at a community hospital. Patients aged 18 or older with acute coronary syndrome or undergoing elective cardiac catheterization were included. Patients with type II myocardial infarction or discharged within 12 hours of catheterization were excluded. Primary outcomes included missed opportunities for GDMT optimization in Phase I and Phase II, pharmacy interventions, and referrals to ambulatory care clinics. Secondary outcomes included hospital length of stay and 30-day hospital readmission. Results: In Phase I, 66% of patients had GDMT optimized by providers, while 34% had opportunities for further optimization. In Phase II, 73% had their medical therapies optimized by providers, and 27% were optimized through clinical care pathways. Pharmacists made 40 interventions to optimize GDMT with six patients who were referred to the cardiometabolic clinic for closer follow-up and management. Discussion: This project demonstrated that incorporating a pharmacist into a multidisciplinary team can significantly facilitate the optimization of GDMT in patients with CAD.

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