Effectiveness of Clinical Pharmacist Interventions on Improving the Appropriateness of Prescription and Treatment Outcomes for Acute Myocardial Infarction Patients: A Before-After Study at a Vietnamese hospital

Introduction: Acute myocardial infarction (AMI) is a leading cause of global morbidity and mortality. Clinical pharmacist intervention offers a promising approach to improve prescription appropriateness and treatment outcomes. This study evaluated the impact of this intervention in treatment for AMI patients.

Methods: A retrospective before-and-after study was conducted on all AMI patients at the Department of Interventional Cardiology, comparing two phases. The pre phase was designed without clinical pharmacist intervention (August 1, 2019, to December 31, 2019) and the post phase with the participation of clinical pharmacists in the prescription process (August 1, 2022, to December 31, 2022); with 6-month post-AMI follow-up periods in each phase. The impact of interventions was evaluated by comparing appropriateness of prescription, treatment outcomes, and adverse drug events (ADEs) between the two phases.

Results: The study included 183 and 211 patients in the pre and post phases, respectively. The overall rates of prescription appropriateness were significantly higher in the post phase (85.8% vs. 48.6%, p < 0.001). The mortality rates within 6 months of AMI discharge in the two phases were 18.6% and 16.5%, respectively (p = 0.604). The proportions of patients who experienced ADEs were 57.4% and 56.4%, respectively (p = 0.845). Clinical pharmacist interventions were associated with a higher rate of overall prescription appropriateness (OR: 6.734; 95% CI: 4.098 – 11.065; p < 0.001).

Conclusions: Clinical pharmacist interventions significantly improved the appropriateness of prescription for AMI treatment but did not reduce occurrence of mortality or ADE.