An innovative program that cut cardiac deaths by 73 percent by linking coronary artery disease patients and teams of pharmacists, nurses, primary care doctors, and cardiologists with an electronic health record also kept the patients healthy two years after they left the program by keeping them in touch with their care givers electronically, according to a randomized study by Kaiser Permanente published in The American Journal of Managed Care this month.
This is the first randomized study to evaluate a follow-up system for patients discharged from a cardiovascular risk reduction service, researchers said. The study was funded by the American College of Clinical Pharmacy.
The Clinical Pharmacy Cardiac Risk Service at Kaiser Permanente Colorado combines Kaiser Permanente's industry-leading electronic health record, Kaiser Permanente HealthConnect�, with proactive patient outreach, education, lifestyle adjustments, and effective medication management. The two-year randomized trial of 421 patients found that patients discharged from the program kept their lipid and blood pressure levels at controlled, healthy levels by receiving electronic reminder letters.
"Because lack of adherence to medications and failure to maintain treatment goals are so high among heart disease patients, we wanted to find out what would happen to the patients after they were discharged from the program but remained in contact with the health care system through our electronic health record," said the study's lead author, Kari L. Olson, a Clinical Pharmacy Specialist with Kaiser Permanente Colorado's Cardiac Risk Reduction program. "The takeaway message here is that we can help support patients in maintaining treatment goals and medication adherence, which is often a challenge with most chronic conditions. Using technology and integrated systems already in place, we can help keep patients healthy for longer and deliver continuity of care in a cost efficient manner."
In the study, 421 patients in the Clinical Pharmacy Cardiac Risk Service with well-controlled blood pressure and cholesterol levels were randomized so that 214 continued in the program to receive intensive direct counseling from the care team. The other 207 patients were discharged from the program back to their primary care physician. The mean age of the trial participants was 72 years old, and 74 percent were male.