Pharmaceutical care of patients with congestive heart failure: Interventions and outcomes

We evaluated a structured pharmaceutical care program for elderly patients (> 65 yrs) with congestive heart failure (CHF) based on objective measures of disease control, quality of life, and use of health care facilities in a randomized, controlled, longitudinal, prospective clinical trial. The 42 p atients in group A received education from a pharmacist on the disease and its treatment, and lifestyle changes that could help control symptoms. Pati ents also were encouraged to monitor their symptoms and comply with prescri bed drug therapy. If necessary, dosage regimens were simplified in liaison with hospital physicians. The 41 control patients (group B) received standa rd care. The following outcome measures were assessed in all patients at ba seline (before the start of the trial) and at 3, 6, 9, and 12 months: 2-min ute walk test, blood pressure, body weight, pulse, forced vital capacity, q uality of life [disease-specific (Minnesota Living with Heart Failure quest ionnaire) and generic (SF-36)], knowledge of symptoms and drugs, compliance with therapy, and use of health care facilities (hospital admissions, visi ts to emergency room, emergency calls). Patients in group A showed improved compliance with drug therapy, which in turn improved their exercise capaci ty compared with those in group B; education on management of symptoms, lif estyle changes, and dietary recommendations were also of benefit. Group A p atients significantly improved knowledge of their drug therapy over the 12- month study and had fewer hospital admissions compared with group B patient s. They also had improved outcomes compared with group B, despite the small samples. An extension of this trial to other sites with pooling of results would provide additional evidence of the value of this structured program in elderly patients with CHF.