Evaluation of Clinical Pharmacy Services in Patients Receiving Antithrombotic Treatment: A Randomized Controlled Trial

Abstract

Background: Antithrombotic drugs are frequently used in the Cardiology ward and patients receiving these drugs are thought to be vulnerable to drug-related problems (DRPs). The aim of this study was to evaluate clinical pharmacy services for the detection and prevention of DRPs in these patients.Methods: This prospective randomized controlled study included 400 patients receiving antithrombotic therapy in the Cardiology ward. The European Pharmaceutical Care Network Classification (PCNE v9.1) was used to assess DRPs. Patients were analyzed for readmission within 1 and 3 months after discharge.Results: The mean age of patients in the control and intervention groups was 67.2 ± 12.2 and 67.8 ± 12.3 years, respectively. Coronary artery disease (74.5%; 74.5%) and hypertension (70.5%; 70%) were the most common diseases. The number of DRPs detected was 561 in the control group and 497 in the intervention group. In both groups, the most frequently identified problem was related to treatment safety (73.62%; 74.25%). This was followed by treatment effectiveness (24.06%; 23.14%). The main causes of DRPs were drug selection (81.11%; 80.88%) and dose selection (19.08%; 16.10%). During the study, 248 (93.23%) recommendations were made for 266 clinically significant DRPs. Of these recommendations, 235 (94.76%) were accepted by physicians. The most common interventions at the drug level were changing the dose (29.65%) and starting a new drug (28.49%). There was no significant difference between the groups in terms of readmission within 1 and 3 months (p > 0.05), but a numerical decrease was observed in the intervention group.Conclusion: In our study, the number of clinically significant DRPs was statistically lower in the intervention group (p < 0.05). The high acceptance rates of the recommendations regarding the problems in the intervention group showed that the clinical pharmacist had a positive contribution to the reduction of DRPs. These results suggest that the inclusion of clinical pharmacists in the healthcare team and the expansion of their services will provide a better-quality healthcare service.