Scientific Poster Session II - Original Research

Original Research
  Sunday, November 12, 2023
  12:45 PM–02:15 PM

Abstract

Introduction: The cardiac catheterization laboratory (CCL) is a unique site for pharmacy services. In November of 2020, the cardiology team at Nebraska Medicine expanded pharmacy services with the addition of a pharmacist to the CCL.

Research Question or Hypothesis: What is the benefit of pharmacist presence in the CCL?

Study Design: The primary outcome of this retrospective chart review included patients who underwent percutaneous coronary intervention (PCI) and discharged from observation status between July 1, 2018 and June 30, 2019 (pre-period) or discharged from the CCL between July 1, 2021 and June 30, 2022 (post-period). Secondary outcomes were measured in all patients who discharged directly from the CCL in the post-period.

Methods: The primary outcome of this study was to compare the percentage of patients discharged from the CCL on each component of appropriate guideline-directed medical therapy after PCI before and after pharmacy presence in the CCL. The primary outcome was measured using a Chi-square test with an alpha of 0.05. Multiple secondary outcomes were also assessed.

Results: Compared to the pre-period, in the post-period, significantly more patients were discharged on high intensity statin therapy (47.9 vs. 78.0%, P<0.0001) and fewer patients were discharged on the contraindicated combination of omeprazole or esomeprazole with clopidogrel (18.7 vs. 3.9%, P<0.0001). Secondary outcomes showed that 23.9% of PCI discharges had a clinically significant pharmacist intervention, of which high intensity statin and clopidogrel drug interaction avoidance were the most common, 96.5% of PCI patients received "Protect Your Stent” education, 13.6% of all discharges had any pharmacist intervention, 771 prescriptions were sent to our outpatient pharmacy, and 66.4% of patients had a medication reconciliation completed.

Conclusion: Pharmacist interventions were associated with higher rates of high intensity statin and lower rates of clopidogrel with omeprazole or esomeprazole following PCI. These data highlight the importance of pharmacy presence on the cardiac care team.

Presenting Author

Molly Kernan PharmD
Nebraska Medicine

Authors

Marion Max PharmD
Nebraska Medicine

Brianne Ritchie PharmD
Nebraska Medicine