Clinical Pharmacist-led Discharge Education Service in Acute Coronary Syndrome

Study Overview
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Brief Summary
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To evaluate the impact of clinical pharmacist-led discharge education service in patients with acute coronary syndrome.

Detailed Description
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This prospective, randomized controlled study was conducted in patients with acute coronary syndrome in an cardiology service of tertiary training and research hospital. The clinical pharmacist, within the scope of the discharge education services, provided medication reconciliation, medication review, individually prepared patient medicine (pill) card, patient education (based on Health Belief Model by using written material and video, and verbally [by using Teach back method especially for patients with low health literacy]) and counseling (using behavior change techniques based on The Capability, Opportunity, and Motivation Behavior model). The control group received standard care.

Official Title
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Evaluation of a Clinical Pharmacist-led Discharge Education Service in Patients With Acute Coronary Syndrome: A Randomized Controlled Study

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Behavioral: Discharge Education Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients admitted to the cardiology department due to acute coronary syndrome Older than 18 years old Exclusion Criteria: Patients who transferred to another ward Patients with active malignancy Patients with alzheimer and/or dementia diagnosis Patient with >%80 visual loss or deaf muteness reported at medical record

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Clinical Pharmacist-led discharge education program<br>Clinical pharmacist-led services | Behavioral: Discharge Education Program<br>* medication reconciliation, medication review, individually prepared patient medicine (pill) card, patient education (based on Health Belief Model by using written material and video, and verbally [by using Teach back method especially for patients with low health literacy]) and counseling (using behavior change techniques based on The Capability, Opportunity, and Motivation Behavior model).<br>|
| No Intervention: Control group<br>Usual care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30 days hospital re-admission for cardiac reasons | Proportion of patients readmitted to hospital for cardiac cause at 1 month | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital re-admission for cardiac reasons | Proportion of patients readmitted to hospital for cardiac cause through 1 year. | 3 months, 6 months, and 12 months | 
| Hospital re-admission for any reasons | Proportion of patients readmitted to hospital for any cause through 1 year. | 1 month, 3 months, 6 months, and 12 months | 
| Emergency service visits | Proportion of patients visited to emergency service through 1 year. | 1 month, 3 months, 6 months, and 12 months | 
| Major Adverse Cardiovascular Event | Proportion of patients had major adverse cardiovascular event through 1 year. | 1 month, 3 months, 6 months, and 12 months | 
| Death for cardiac reason | Proportion of patients died for cardiac cause through 1 year. | 1 month, 3 months, 6 months, and 12 months | 
| Death for any reason | Proportion of patients dying for any cause through 1 year. | 1 month, 3 months, 6 months, and 12 months | 
| Medication Adherence | Adherence to Cardioprotective Medications (Clopidogrel, Statins, Beta-blockers, Angiotensin-converting enzyme (ACE) inhibitors/ Angiotensin receptor blocker (ARB) through 1 year assessed by Medication Adherence Report Scale (MARS). MARS assesses adherence through 5-item, summed to give a scale score ranging from 5 to 25, where higher scores indicate higher levels of reported adherence. | 1 month, 3 months, 6 months, and 12 months | 
| Quality of Life Measurement | Change in quality of life from baseline assessed with EuroQol questionnaire EQ-5D-3L through 1 year. (EQ-5D-3L) is a standardized scale for use as a measure of the quality of life. The EQ-5D-3L descriptive system comprises the following 5 dimensions (5D): mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 3 levels (3L): no problems (1 point), some problems (2 points), extreme problems (3 points). This gives a total of 245 different health states, adding unconscious and dead. | 1 month, 3 months, 6 months, and 12 months | 
| Achieved Target Low-density Lipoprotein Value | Rate of patients achieved target low-density lipoprotein value | 6 months, 12 months |