The Effect of Cardiovascular Credentialed Pharmacists on Process Measures and Outcomes in Myocardial Infarction and Heart

OBJECTIVE The purpose of this study was to determine if institutions with inpatient cardiovascular creden-tialed pharmacists exhibit improved quality measures for acute myocardial infarction (AMI) and heart fail-ure (HF) care compared with institutions without inpatient cardiovascular credentialed pharmacists. METHODS We conducted a multicenter, retrospective, cross-sectional, matched case-control study. Hos-pitals with at least one Added Qualification in Cardiology (AQCV) inpatient pharmacist were included in the case group. Each case group hospital was matched to hospitals without an AQCV pharmacist by region, number of cardiovascular discharges, and teaching hospital designation in a 1:3 ratio (case:control). The 34 AQCV hospitals were matched to 102 non-AQCV hospitals. The proportions of discharges meeting HF and AMI process of care measures and 30-day outcomes (re-admission and mortality) for each hospital were determined from public data and compared between the case and control groups. RESULTS Hospitals with AQCV pharmacists performed better on process of care measures than hospitals without AQCV pharmacists (odds ratio 1.41, 95 % confidence interval 1.25–1.58, p<0.0001, p<0.001 for heterogeneity), which was mainly driven by the aspirin on discharge for AMI and angiotensin-con-verting enzyme inhibitor or angiotensin receptor blocker on discharge for HF measures. No difference