DefinePK

Abstract

Objective: To explore the service model and effect of pharmacist-conducted medication reconciliation (MR) in geriatric patients with coronary atherosclerotic heart disease (coronary heart disease, CHD), so as to provide a reference for grass-roots pharmacists in MR implementation.
Methodology: This was a retrospective study. A total of 200 CHD patients admitted to the department of Geriatrics in the First Affiliated Hospital of Hebei North University from January 2023 to July 2024 were randomly divided into a control group (n = 100) and an experimental group (n = 100). The control group was given conventional clinical treatment, while the experimental group was additionally serviced with standardized pharmacist-conducted MR. Both groups were followed up till six months after discharge. PIM use during hospitalization, length of hospital stay, drug costs, incidence of ADRs, patient satisfaction, and medication adherence scores one and six months after discharge were compared between the two groups.
Result: Compared with the control group, the experimental group exhibited reduced PIMs, length of hospital stay, drug costs, and incidence of ADRs (P < 0.05). Patient satisfaction of the experimental group was higher than that of the control group (P < 0.05). Medication adherence of both groups after discharge was significantly improved compared to that at admission, and the improvement in the experimental group was significantly better than that in the control group, with a statistically significant difference (P < 0.05).
Conclusion: Standardized MR services for CHD patients may be conducive to ensuring rational medication and improving clinical effect.