Objective: To evaluate the effects of pharmaceutical care provision on patients admitted to Patthalung Hospital who had acute coronary syndromes and hypercholesterolemia. The outcomes that were measured included the evaluation of the use of a statin, a patient's compliance to the medication, patient's quality of life, patient's knowledge of both the drug therapy and disease, and patient's follow-up visit before schedule.
Material and Methods: This was a quasi experimental study of the patients in the pre-intervention phase who were admitted to the hospital between April and October 2004 and patients who were in the post-intervention phase who were admitted between November 2004 and March 2005. There were 20 patients in each group. The patients in the pre-intervention phase were matched with the patients in the post-intervention phase in the ratio of 1:1. The patients in the pre-intervention phase received the usual recommended care and the pharmacists did a retrospective review of statin use. The patients in the post-intervention phase received pharmaceutical care in which a pharmacist counseled the patients on both the drug therapy and the disease and at the same time the pharmacists also evaluated the practice of prescribing statin by physician. The patients in the postintervention phase were scheduled for three consecutive follow up visits with an interval of one month. Data was collected during the hospital stay and also in the out patient department.
Results: After discharge, it was found that, of those patients who attended follow up visits more than once, there were fewer patients in the pre-intervention phase than there were in the post-intervention phase (45%, 45%) and (100%,100%) respectively (p   <    0.001). The patients in the post-intervention phase adhered more to statin therapy than did the pre-intervention phase group (99% vs. 57%, p   <   0.001). In both groups eighty-five percent of statin prescribed was found to be appropriate according to the indication criteria. In contraindicated patients statins were not prescribed. A lipid profile was monitored in 56% of the patients in pre-intervention phase and all the patients in the post-intervention phase. Twenty-two percent and seventy percent of the patients in the pre and post-intervention phase, respectively, achieved the target LDL-C goal of less than 100 mg/dl. Physicians accepted the pharmacists'recommendations regarding drug therapy in 22 out of 38 recommendations. Patients' knowledge scores concerning drug therapy and the disease in the post-intervention phase significantly increased after the study (10.20 vs. 5.00, p < 0.001). The quality of life scores also improved significantly (86.85 vs. 71.15, p  <  0.001). The number of patients who needed extra visits before the scheduled visits were not significantly different between either of the groups (6 vs. 4, p > 0.05).
Conclusion: This study has shown that the involvement of pharmaceutical care of acute coronary syndrome patients with elevated cholesterol was beneficial. Involvement improved patients' compliance with statin therapy and the monitoring for lipid profiles. The proportion of patients who achieved the LDL-C target goal increased as did their knowledge of the drug therapy and the disease along with an increased quality of life.