Heart disease is the leading cause of death in the United States and accounts for more than $200 billion each year in healthcare costs, according to the CDC. Increasingly, pharmacists are practicing in cardiology across the spectrum of care ranging from ambulatory clinics that specialize in heart failure to intensive care units where patients have recently been diagnosed with decompensated heart failure or are recovering from cardiac surgery.
A multidisciplinary team with a pharmacist benefits patients with cardiovascular disease since they often have comorbid conditions and complex medication regimens that can include the use of high-risk medications. A pharmacist with expert knowledge in cardiology can ensure optimization of medical therapies, drug interaction screening, and provide drug information.
Specifically in the ambulatory care setting, pharmacists specializing in cardiology can perform frequent visits to ensure heart failure patients get their target doses of medications that reduce morbidity and mortality, or adjust antihypertensive medications to reach the recommended blood pressure goal. Optimizing the medication regimen, coupled with concentrated education on both the disease state and drug therapies, can help keep patients out of the hospital, decrease complications, and improve overall quality of life.
In the acute care setting, many cardiovascular patients receive multiple diagnoses. During an initial hospitalization, a patient may present with symptoms of a heart attack, and then be diagnosed with diabetes, hypertension, and hyperlipidemia. Pharmacists make a huge impact on these patients by offering guidance on selecting a medication regimen that treats multiple disease states. During transitions of care, pharmacists also help select a regimen that allows patients to manage their own care at home.
Many of these patients need multiple medications to adequately treat their cardiovascular diseases. Cardiology pharmacists are uniquely positioned to provide in-depth education to patients who are on high-risk cardiology medications such as anticoagulants and antiarrhythmics.
Cardiology pharmacists can also aid in quality improvement projects. Evaluating the appropriate prescribing of high-risk therapies or attainment of the therapeutic range for anticoagulants can help in medical decision-making. Pharmacist guidance can ultimately lead to enhanced utilization of medical therapies and improved patient outcomes.
Lastly, participation in order set development is a key role that pharmacists can play in improving care in cardiology. The creation of order sets for disease states like acute coronary syndromes can lead to increased prescribing of newer antiplatelet therapies or aid in smoking cessation.