Evaluation of Pharmacist Medication Review Service in an Outpatient Heart Failure Clinic

J Pharm Pract. 2020 Dec;33(6):820-826. doi: 10.1177/0897190019842696. Epub 2019 May 5.


Purpose: The purpose of this study was to evaluate the impact of pharmacist medication reviews on drug-related problems (DRPs) in a population with ambulatory heart failure (HF).

Methods: The HF pharmacist medication review service incorporated a comprehensive medication review note provided to the cardiologist in a HF clinic. A retrospective chart review was performed on 64 control patients with no previous pharmacist review and 64 intervention patients who had a pharmacist medication review. The primary end point was the number of DRPs identified per patient in the intervention group 2 weeks after pharmacist medication review compared to the number of DRPs identified per patient in the control group.

Results: The average DRPs per patient was reduced from 2.80 to 1.95 in intervention group after pharmacist intervention. There was a statistically significant difference between the average DRPs per patient in the control and intervention groups, 2.55 DRPs versus 1.95 DRPs per patient, respectively (P = .016). Medication adherence (78%), renal dosing (67%), hypertension (58%), and HF DRPs (55%) had the highest acceptance rate. The majority of DRP recommendations in the intervention (87%) and control groups (87%) were high-impact recommendations.

Conclusions: Pharmacist medication reviews in an ambulatory HF clinic lead to significantly fewer DRPs.

Keywords: drug-related problems; heart failure; pharmacist.

Publication types

  • Review

MeSH terms

  • Drug-Related Side Effects and Adverse Reactions
  • Heart Failure* / diagnosis
  • Heart Failure* / drug therapy
  • Heart Failure* / epidemiology
  • Humans
  • Outpatients
  • Pharmacists
  • Retrospective Studies