JUSTIFICATION FOR EXPANDING THE PHARMACIST’S ROLE IN THE PREVENTION OF CORONARY HEART DISEASE AT SECONDARY AND TERTIARY LEVELS OF MEDICAL CARE
DOI:
https://doi.org/10.32689/2663-0672-2024-3-7Keywords:
pharmaceutical care, Good Pharmacy Practice, pharmaceutical services, prevention, ischemic heart disease, arterial hypertension, diabetes mellitus, patient safetyAbstract
Problem statement. The development of sustainable health care systems involves improving the population's access to quality patient-oriented medical services, safe and effective medicines, in particular for patients with coronary heart disease. At the international level, there is a reorientation of the provision of pharmaceutical services from pharmaceutical provision to patient-oriented pharmaceutical care. The transformation of the provision of pharmaceutical services requires the development and justification of better models of the provision of pharmaceutical care. Objective. The aim of this study is to justify and expand the pharmacist’s role in a comprehensive approach to the prevention of coronary heart disease (CHD) with comorbid conditions at secondary and tertiary levels of healthcare, to improve adherence to treatment, reduce the number of unplanned hospitalizations, minimize disability and alleviate the burden on the healthcare system. Materials and methods. The study materials included international and national concepts and strategies, regulatory documents on the subject, clinical guidelines from ESC/AHA, American pharmaceutical care protocols and information from scientific databases such as Scopus, Web of Science, Cochrane Library and PubMed. The methods used in this research include comparative analysis, synthesis, generalization, deduction and induction. Results and discussion. It has been determined that, on a global level, there is a shift in pharmaceutical services from drug provision to pharmaceutical care for patients with CHD and comorbid conditions. The expansion of the roles and functions of Good Pharmacy Practice (GPP) has occurred through the integration of pharmacists into primary healthcare and their participation in multidisciplinary teams involved in the prevention of CHD at the secondary and tertiary levels of medical care. The need for improved regulatory oversight of pharmaceutical services has been justified. A review and expansion of pharmacist protocols for providing pharmaceutical care to patients with cardiovascular diseases (CVDs), in accordance with medical care protocols and clinical guidelines for “Stable Coronary Heart Disease”, is recommended. Conclusions. The functional expansion of the pharmacist’s role has been substantiated in the context of comprehensive approaches to CHD prevention with comorbid conditions at secondary and tertiary levels of healthcare. The effectiveness of pharmacists in improving treatment adherence among patients has been proven. The impact of pharmacists, as part of multidisciplinary teams, on reducing the number of unplanned hospitalizations, population disability and the burden on the healthcare system has been confirmed.
References
Білоусова Н., Соловйов С., Кабачна А. Теоретико-методичні засади оцінки медичних технологій: монографія. Київ: Тов «Юрка Любченка», 2023. 220 с. URL: https://lib.iitta.gov.ua/id/eprint/736032/1/monografiya_blok.pdf.
Даценко І. С. Науково-методичні підходи до удосконалення фармацевтичного забезпечення хворих на легеневу гіпертензію: автореф. Дисертація на здобуття наукового ступеня доктора філософії. Київ, 2023. URL: http://ir.nuozu.edu.ua:8080/bitstream/lib/4846/1/Dr_dacenko.pdf.
Кірсанов Д. Аптечні продажі за підсумками І півріччя 2024 року. Аптека-online. 2024. 22 лип. URL: https://www.apteka.ua/article/698730.
Левицька О. Р. Клініко-фармацевтичне обґрунтування концептуальної моделі медикаментозного забезпечення хворих з гострими порушеннями мозкового кровообігу: автореф. Докторська дисертація. Львів, 2021. 48 с. URL: https://nauka.meduniv.lviv.ua/wp-content/uploads/disertatsiya_levitska.pdf.
Максимович Н. М., Заліська О. М. Analysis of the list of medicines for arterial hypertension therapy during pregnancy. Farmatsevtychnyi zhurnal. 2024. No. 1. P. 3–12. URL: https://doi.org/10.32352/0367-3057.1.24.01 (date of access: 15.10.2024).
Належна аптечна практика: Стандарти якості аптечних послуг (Спільна настанова МФФ/ВООЗ з НАП): Стандарт Всесвіт. орг. охорони здоров'я від 01.01.2011 р. URL: https://zakon.rada.gov.ua/laws/show/897_009#Text (дата звернення: 03.10.2024).
Немченко А. С., Попова І. А., Демченко Н. В. Дослідження фармацевтичного забезпечення хворих на серцево-судинні захворювання в рамках програми «Доступні ліки». Health & Education. 2024. № 1. С. 121–130. URL: https://doi.org/10.32782/health-2024.1.16 (дата звернення: 30.09.2024).
Про затвердження протоколів фармацевта: Наказ МОЗ України від 05.01.2022 р. № 7. URL: https://zakon.rada.gov.ua/rada/show/v0007282-22#Text.
Про лікарські засоби: Закон України від 28.07.2022 р. № 2469-IX: станом на 17 верес. 2023 р. URL: https://zakon.rada.gov.ua/laws/show/2469-20#Text (дата звернення: 15.10.2024).
Уніфікований клінічний протокол первинної, вторинної (спеціалізовааної) та третинної (високоспеціалізованої) медичної допомоги «Стабільна ішемічна хвороба серця»: Уніфік. клін. протокол від 24.12.2021 р. № ГС 2021-2857. URL: https://www.dec.gov.ua/mtd/stabilna-ishemichna-hvoroba-serczya/.
2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines / P. K. Whelton et al. Hypertension. 2018. Vol. 71, no. 6. P. 1269–1324. URL: https://doi.org/10.1161/hyp.0000000000000066 (date of access: 15.10.2024).
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice / F. L. J. Visseren et al. European Heart Journal. 2021. Vol. 42, no. 34. P. 3227–3337. URL: https://doi.org/10.1093/eurheartj/ehab484 (date of access: 15.10.2024).
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines / S. S. Virani et al. Circulation. 2023. URL: https://doi.org/10.1161/cir.0000000000001168 (date of access: 02.10.2024).
2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes / N. Marx et al. European Heart Journal. 2023. URL: https://doi.org/10.1093/eurheartj/ehad192 (date of access: 15.10.2024).
2024 ESC Guidelines for the management of chronic coronary syndromes / C. Vrints et al. European Heart Journal. 2024. URL: https://doi.org/10.1093/eurheartj/ehae177 (date of access: 15.10.2024)
2024 ESC Guidelines for the management of elevated blood pressure and hypertension / J. W. McEvoy et al. European Heart Journal. 2024. URL: https://doi.org/10.1093/eurheartj/ehae178 (date of access: 15.10.2024).
A systematic review of the role of community pharmacists in the prevention and control of cardiovascular diseases: the perceptions of patients / N. F. Motlohi et al. Systematic Reviews. 2023. Vol. 12, no. 1. URL: https://doi.org/10.1186/s13643-023-02338-7 (date of access: 15.10.2024).
Addendum to: 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Journal of the American College of Cardiology. 2019. URL: https://doi.org/10.1016/j.jacc.2019.03.016 (date of access: 02.10.2024).
An Evaluation of Interventions by Clinical Pharmacists in a Tertiary Hospital/. L. Lau et al. Malaysian Journal of Pharmacy. 2021. Vol. 7, no. 2. P. 3–6. URL: https://doi.org/10.52494/icuz1511 (date of access: 15.10.2024).
Anderson S. L., Marrs J. C. A Review of the Role of the Pharmacist in Heart Failure Transition of Care. Advances in Therapy. 2018. Vol. 35, no. 3. P. 311–323. URL: https://doi.org/10.1007/s12325-018-0671-7 (date of access: 15.10.2024).
Bilousova N. A., Mykhalchuk V. M. Analytical review of the inf l uence of socio-economic factors on the state of pharmaceutical care for patients with cardiovascular diseases. Polski Merkuriusz Lekarski. 2024. Vol. 52, no. 3. P. 347–355. URL: https://doi.org/10.36740/merkur202403112 (date of access: 15.10.2024).
Bilousova N. Primary prevention of a coronary heart disease within the structure of pharmaceutical care provision: functional role fulfillment of the pharmacist. Pharmaceutical Review. 2024. Vol. 71, no. 3. P. 42–52. URL: https://doi.org/10.11603/2312-0967.2024.3.14862
Cardiology in Clinical Pharmacy Practice Module - The School of Pharmacy and Pharmaceutical Sciences – Trinity College Dublin. The School of Pharmacy and Pharmaceutical Sciences - Trinity College Dublin. URL: https://pharmacy.tcd.ie/postgraduate/cardiology_clin_pharm_mod.php (date of access: 15.10.2024). (date of access: 09.10.2024).
CLS H. L. P. M. B. B. A. Specialized Certifications for Cardiology Pharmacy. Philadelphia College of Osteopathic Medicine | PCOM. URL: https://www.pcom.edu/academics/programs-and-degrees/doctor-of-pharmacy/school-of-pharmacy/blog/certifications-for-cardiology-pharmacy.html (date of access: 09.10.2024).
Community pharmacy regulatory and practice models in eastern Europe and central Asia. Copenhagen: WHO Regional Office for Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO. URL: https://iris.who.int/bitstream/handle/10665/376552/9789289060776-eng.pdf?sequence=1&isAllowed=y (date of access: 29.09.2024).
Diagnosis and Classification of Diabetes: Standards of Care in Diabetes–2024 / N. A. ElSayed et al. Diabetes Care. 2023. Vol. 47, Supplement_1. P. S20–S42. URL: https://doi.org/10.2337/dc24-s002 (date of access: 03.10.2024).
Effect of a 36-month Pharmaceutical Care Program on the Coronary Heart Disease Risk in Elderly Diabetic and Hypertensive Patients / P. R. Obreli Neto et al. Journal of Pharmacy & Pharmaceutical Sciences. 2011. Vol. 14, no. 2. P. 249. URL: https://doi.org/10.18433/j3259q (date of access: 15.10.2024).
Effects of a pharmaceutical care intervention on clinical outcomes and patient adherence in coronary heart disease: the MIMeRiC randomized controlled trial / M. J. Östbring et al. BMC Cardiovascular Disorders. 2021. Vol. 21, no. 1. URL: https://doi.org/10.1186/s12872-021-02178-0 (date of access: 15.10.2024).
EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries / K. Kotseva et al. European Journal of Preventive Cardiology. 2015. Vol. 23, no. 6. P. 636–648. URL: https://doi.org/10.1177/2047487315569401 (date of access: 15.10.2024).
Framework for action on the health and care workforce in the WHO European Region 2023-2030: Draft resolution cosponsored by Andorra, Austria, Belgium, Bulgaria, Croatia, Cyprus, Czechia, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kazakhstan, Latvia, Lithuania, Luxembourg, Malta, Monaco, Netherlands (Kingdom of the), Poland, Portugal, Republic of Moldova, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Tajikistan, Türkiye and Ukraine of 26.10.2023 no. EUR/RC73/CONF./4 Provisional agenda item. URL: https://www.juniordoctors.eu/sites/default/files/2023-12/73wd08e-HealthCareWorkforce-230575.pdf (date of access: 15.10.2024).
Henman M. C., Ravera S., Lery F.-X. Council of Europe Resolution on the Implementation of Pharmaceutical Care–A Step Forward in Enhancing the Appropriate Use of Medicines and Patient-Centred Care. Healthcare. 2024. Vol. 12, no. 2. P. 232. URL: https://doi.org/10.3390/healthcare12020232 (date of access: 15.10.2024).
Hospital Pharmacy Professionals and Cardiovascular Care: A Cross-Sectional Study Assessing Knowledge, Attitudes, and Practices in Saudi Arabia / F. Alzahrani et al. Healthcare. 2024. Vol. 12, no. 6. P. 630. URL: https://doi.org/10.3390/healthcare12060630 (date of access: 15.10.2024).
Human Healthcare and Its Pharmacy Component from a Safety Point of View / N. Tkachenko et al. Pharmacy. 2024. Vol. 12, no. 2. P. 64. URL: https://doi.org/10.3390/pharmacy12020064 (date of access: 15.10.2024).
Impact of continuous pharmaceutical care led by clinical pharmacists during transitions of care on medication adherence and clinical outcomes for patients with coronary heart disease: a prospective cohort study / L. Gao et al. Frontiers in Pharmacology. 2023. Vol. 14. URL: https://doi.org/10.3389/fphar.2023.1249636 (date of access: 15.10.2024).
Impacts of Clinical Pharmacist Intervention on the Secondary Prevention of Coronary Heart Disease: A Randomized Controlled Clinical Study / H. Xu et al. Frontiers in Pharmacology. 2019. Vol. 10. URL: https://doi.org/10.3389/fphar.2019.01112 (date of access: 15.10.2024).
International Pharmaceutical Federation (FIP). Cardiovascular diseases: A handbook for pharmacists. The Hague: International Pharmaceutical Federation; 2022. P. 108. URL: https://www.fip.org/file/5251 (date of access: 15.10.2024).
K. Reilly. The Pharmacist’s Guide to Acute Coronary Syndrome. U.S. Pharmacist. The Pharmacists resource for Clinical Excellence. 2020. Vol. 2. URL: https://www.uspharmacist.com/article/the-pharmacists-guide-to-acute-coronary-syndrome.
Kayyali R., Peletidi A., Nabhani-Gebara S. The role of pharmacists in cardiovascular disease prevention: Qualitative studies from the United Kingdom and Greece. Journal of Research in Pharmacy Practice. 2019. Vol. 8, no. 3. P. 112. URL: https://doi.org/10.4103/jrpp.jrpp_19_3 (date of access: 15.10.2024).
Lifestyle and risk factor management in people at high cardiovascular risk from Bulgaria, Croatia, Poland, Romania and the United Kingdom who participated in both the EUROASPIRE III and IV primary care surveys / G. De Backer et al. European Journal of Preventive Cardiology. 2016. Vol. 23, no. 15. P. 1618–1627. URL: https://doi.org/10.1177/2047487316645474 (dat e of access: 15.10.2024)
Olkhovska A. B., Malyi V. V., Lisna А. G. A scientific and theoretical approach to the development of the process model for managing personified marketing communications in pharmacy. Social Pharmacy in Health Care. 2022. Vol. 8, no. 1. P. 51–62. URL: https://doi.org/10.24959/sphhcj.22.234 (date of access: 30.09.2024).
Omboni S., Caserini M. Effectiveness of pharmacist’s intervention in the management of cardiovascular diseases. Open Heart. 2018. Vol. 5, no. 1. P. e000687. URL: https://doi.org/10.1136/openhrt-2017-000687(date of access: 15.10.2024).
Pharmaceutical Care Network Europe definition of quality indicators for pharmaceutical care: a systematic literature review and international consensus development / K. Fujita et al. International Journal of Clinical Pharmacy. 2023. URL: https://doi.org/10.1007/s11096-023-01631-8 (date of access: 15.10.2024).
Possible solution for the Global problem of the high cost of medicines / P. Oliinyk et al. Proceeding of the Shevchenko Scientific Society. Medical Sciences. 2024. Vol. 73, no. 1. URL: https://doi.org/10.25040/ntsh2024.01.01 (date of access: 15.10.2024).
Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries / K. Kotseva et al. European Journal of Preventive Cardiology. 2020. P. 204748732090869. URL: https://doi.org/10.1177/2047487320908698 (date of access: 15.10.2024).
Resolution CM/Res (2020)3 on the implementation of pharmaceutical care for the benefit of patients and Health services: Resolution no. CM/Res (2020)3. URL: https://rm.coe.int/09000016809cdf26 (date of access: 15.10.2024).
Role of community pharmacists in cardiovascular diseases-related health promotion and dyslipidemia management in Malaysia: A nationwide cross-sectional study / F. F. Ismail et al. PLOS ONE. 2023. Vol. 18, no. 9. P. e0290883. URL: https://doi.org/10.1371/journal.pone.0290883 (date of access: 15.10.2024).
Screening for Glucose Perturbations and Risk Factor Management in Dysglycemic Patients With Coronary Artery Disease–A Persistent Challenge in Need of Substantial Improvement: A Report From ESC EORP EUROASPIRE V / G. Ferrannini et al. Diabetes Care. 2020. Vol. 43, no. 4. P. 726–733. URL: https://doi.org/10.2337/dc19-2165 (date of access: 15.10.2024).
Sustainable Development Goals. World Health Organization (WHO). URL: https://www.who.int/data/gho/data/themes/sustainable-development-goals (date of access: 15.10.2024).
Terrie Y. Counseling Patients on MI Recovery and Recurrence Prevention. US Pharm. 2018. Vol. 43(2)HS-8-HS-12. URL: https://www.uspharmacist.com/article/counseling-patients-on-mi-recovery-and-recurrence-prevention.
The Clinical Significance of Drug–Food Interactions of Direct Oral Anticoagulants / G. Grześk et al. International Journal of Molecular Sciences. 2021. Vol. 22, no. 16. P. 8531. URL: https://doi.org/10.3390/ijms22168531 (date of access: 03.10.2024).
WHO European Region. Ukraine. Datadot. URL: https://data.who.int/countries/804 (date of access: 29.09.2024).
