Abstract
The purpose of this study was to determine the impact of pharmacist and pharmacy student involvement with an interdisciplinary cardiac rehabilitation program in the outpatient setting. The study included 192 patients who were seen following discharge from an acute care hospital between June 2008 and September 2010. The pharmacy team educated patients on their medications, conducted medication reconciliation, and made patient and provider interventions when appropriate. The pharmacist met with the cardiac rehabilitation team before these sessions to identify areas of focus and concern. The team met again after the sessions to reconcile medication lists and identify areas for follow-up. Of the 192 patients seen, an intervention was initiated in 157 (81.8%), for a total of 467 interventions (mean 2.43 interventions/patient). Medication reconciliation interventions not requiring a physician response comprised 79.9% of total interventions, most commonly involving an over-the-counter medication not initially reported (18%). Seventy-six patient interventions and 18 provider interventions were also made; of these, 92% of the patient interventions were accepted, and 72% of the provider interventions were accepted. The most common patient intervention was changing the administration time of a medication (36.8%), and the most common provider intervention was avoidance of a significant drug interaction (33.3%). Pharmacists can play a vital role as part of an interdisciplinary cardiac rehabilitation team to ensure proper adherence to cardiac medications and patient safety through patient education and interventions.