Impact of clinical pharmacist-led pharmacotherapy on long-term outcomes in cardiovascular in-patients: A three-year cohort study.

Although short-term benefits of clinical pharmacist involvement-such as improved medication adherence and risk-factor control-have been reported in cardiovascular patients, evidence on its impact on long-term outcomes remains limited and inconsistent. We retrospectively reviewed 100 in-patients with cardiovascular diseases treated at our center from January 2019 to December 2021 and followed them for 36 months (to December 2024). Patients were classified into a pharmacist-intervention group (n = 50) or a usual-care group (n = 50) according to the presence of pharmacist-led medication management. Baseline characteristics were comparable (all P > .46). Primary assessments included inappropriate medication rate, 8-item Morisky Medication Adherence Scale-8 sub-scores, blood pressure and low-density lipoprotein cholesterol target attainment, cardiac-function indices (left-ventricular ejection fraction, left-ventricular end-diastolic diameter, and N-terminal pro-B-type natriuretic peptide), drug-related adverse events, and 36-month major adverse cardiovascular events, all-cause readmission, and all-cause mortality. The pharmacist group showed a markedly lower overall rate of inappropriate prescriptions than usual care (8.0% vs 28.0%; χ2 = 6.783, P = .009). Morisky Medication Adherence Scale-8 scores for initiative, correctness, and medication knowledge were significantly higher (8.20 ± 0.58, 7.91 ± 0.49, 8.03 ± 0.73; all P = .001). At 36 months, blood pressure and left-ventricular ejection fraction targets were achieved more often (60.0% vs 36.0%, P = .016; 44.0% vs 24.0%, P = .034). Left-ventricular ejection fraction rose by an absolute 10.0 ± 8.5 percentage points from baseline (vs 4.5 ± 7.5 points with usual care, P < .001); reductions in left-ventricular end-diastolic diameter and N-terminal pro-B-type natriuretic peptide were likewise greater (P = .011 and 0.009). Drug-related AEs occurred less frequently (8.0% vs 24.0%, P = .029). Major adverse cardiovascular events (10.0% vs 26.0%, P = .038) and all-cause readmission (16.0% vs 36.0%, P = .024) were reduced, whereas mortality did not differ significantly (2.0% vs 10.0%, P = .093). Over 3 years, pharmacist-led medication management significantly improved prescription appropriateness, medication adherence, risk-factor control, and cardiac-remodeling parameters, while reducing drug-related adverse events, major adverse cardiovascular events, and hospital readmissions. These findings support the integration of clinical pharmacists into routine cardiovascular care.

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