Healthcare Utilisation and Clinical Outcomes in Older Cardiovascular Patients Receiving Comprehensive Medication Management Services: A Nonrandomised Clinical Study

Andrea Brajković, Lorena Bosnar, Mariana Martins Gonzaga do Nascimento, Ingrid Prkačin, Antonija Balenović, Djenane Ramalho de Oliveira and Iva Mucalo
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Andrea Brajković: Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
Lorena Bosnar: Health Care Centre Zagreb–Centre, 10000 Zagreb, Croatia
Mariana Martins Gonzaga do Nascimento: College of Pharmacy, Centre for Pharmaceutical Care Studies, Federal University of Minas Gerais, Belo Horizonte, Belo Horizonte 31270-901, Brazil
Ingrid Prkačin: Department of Internal Medicine, School of Medicine, University of Zagreb, Merkur University Hospital, 10000 Zagreb, Croatia
Antonija Balenović: The Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
Djenane Ramalho de Oliveira: College of Pharmacy, Centre for Pharmaceutical Care Studies, Federal University of Minas Gerais, Belo Horizonte, Belo Horizonte 31270-901, Brazil
Iva Mucalo: Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia

IJERPH, 2022, vol. 19, issue 5, 1-11

Abstract: The objective of this study was to evaluate the impact of comprehensive medication management (CMM) services on healthcare utilisation and cardiovascular risk factors among older patients with established cardiovascular diseases (CVDs). This quasi-experimental study that was performed at the Croatian primary care ambulatory clinic included patients aged 65 to 80 years. Patients were divided into intervention (65 patients) and control groups (68 patients) and were followed-up for one year. Pharmacists provided face-to-face consultations to patients from the intervention group. Groups were compared with regards to the clinical parameters (blood pressure, HbA1c, LDL, TC) and healthcare utilisation (hospital admission, emergency visits, unplanned GP visits). The CMM intervention significantly improved systolic blood pressure ( p = 0.038), diastolic blood pressure ( p = 0.001), total cholesterol ( p = 0.014), low-density lipoprotein cholesterol ( p = 0.005), and glycosylated haemoglobin ( p = 0.045) in comparison with the control group. Patients included in CMM services had statistically and clinically lower systolic (−9.02 mmHg, p < 0.001) and diastolic blood pressure (−4.99 mmHg, p < 0.001) at the end of the study. The number of hospital admissions and unplanned GPs visits were 3.35 (95% CI 1.16–10.00) and 2.34 (95% CI 1.52–3.57) times higher in the control group compared to the intervention group, respectively. This study demonstrated that pharmacists providing CMM services can significantly contribute to better clinical outcomes and lower healthcare utilisation, thus potentially contributing to total healthcare savings.

Keywords: medication management services; nonrandomised; primary care; cardiovascular; older patients (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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