Heart-failure patients take their medicine more reliably when under the care of a pharmacist

Heart-failure patients take their medicine more reliably when under the care of a pharmacist, resulting in fewer emergency-room visits and hospital stays as well as lower health-care costs, according to a study from the University of North Carolina at Chapel Hill School of Pharmacy.

The American Heart Association says more than 5 million people in the United States are in various stages of heart failure with total health-care costs exceeding $29 billion.

The UNC study, published in the May 15, 2007 issue of the Annals of Internal Medicine, included 314 low-income patients with heart failure. They were placed into two groups: one received typical services from a pharmacist; the other received care from a specially trained pharmacist who had access to customized educational materials, provided comprehensive instruction to participants and reminded them to refill their prescriptions.

"For every $1 we spent on the intervention group, the health-care system gained $14 in savings by decreasing emergency-room visits and hospitalization," said Michael D. Murray, the Mescal S. Ferguson Distinguished Professor at the UNC School of Pharmacy and lead author of the study.

Compared to patients in the control group, those who received special intervention:

• took their medications 16 percent more consistently,
• visited the emergency room and were hospitalized 19 percent less, and
• had direct annual health-care costs nearly $3,000 lower per patient.

"The key to the success of our intervention was taking time with patients to create a regular schedule for taking their medicines that fit their lifestyle," said James Young, the intervention pharmacist involved in the study.

"We made sure that patients understood how their medications worked and why taking them consistently was so important," said Young, a research pharmacist with Wishard Health Services in Indianapolis and a co-author of the study.

The study investigators created special patient-specific materials designed to help patients with lower levels of health literacy. For example, heart patients taking an ACE inhibitor received their pills in a bottle marked with an ace of hearts sticker. A corresponding information sheet, designed to be easy to read and understand, was also marked with the ace-of-hearts.