Schulz, Martin ORCID: 0000-0002-5876-7322, Griese-Mammen, Nina, Anker, Stefan D., Koehler, Friedrich ORCID: 0000-0003-0441-4123, Ihle, Peter, Ruckes, Christian, Schumacher, Pia M., Trenk, Dietmar, Boehm, Michael and Laufs, Ulrich (2019). Pharmacy-based interdisciplinary intervention for patients with chronic heart failure: results of the PHARM-CHF randomized controlled trial. Eur. J. Heart Fail., 21 (8). S. 1012 - 1022. HOBOKEN: WILEY. ISSN 1879-0844

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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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schulz, MartinUNSPECIFIEDorcid.org/0000-0002-5876-7322UNSPECIFIED
Griese-Mammen, NinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anker, Stefan D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koehler, FriedrichUNSPECIFIEDorcid.org/0000-0003-0441-4123UNSPECIFIED
Ihle, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruckes, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schumacher, Pia M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trenk, DietmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boehm, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laufs, UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-145720
DOI: 10.1002/ejhf.1503
Journal or Publication Title: Eur. J. Heart Fail.
Volume: 21
Number: 8
Page Range: S. 1012 - 1022
Date: 2019
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1879-0844
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
IMPROVE MEDICATION ADHERENCE; CLAIMS DATA; PROGRAMMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/14572

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