Impact of a Pharmacist-Led Amiodarone Monitoring Service (AMS) in a Cardiology Practice M.Moss,A.Bruckelmeyer,P.Carson,N.Wilkins,K.McKnight,T.Christopher,A.Patel Carolinas HealthCare System - PGY1 AmCare - Charlotte, NC
Background/Purpose: Amiodarone is a class III antiarrhythmic commonly prescribed for the treatment of ventricular and supraventricular tachyarrhythmias. Amiodarone has the potential for serious adverse events including liver, pulmonary, thyroid, and ocular toxicity. Amiodarone prescribing information recommends certain amiodarone monitoring parameters; however, clinical adherence to these recommendations is suboptimal and frequency of monitoring is debatable. Available studies suggest pharmacist-led Amiodarone Monitoring Services (AMS) may improve adherence to recommended monitoring guidelines and identification of amiodarone-related adverse effects. Increased adherence to monitoring parameters may reduce hospitalizations and ER visits related to amiodarone associated toxicities. The primary objective of this study was to evaluate the effect of a pharmacist-led AMS on adherence to recommended amiodarone therapeutic monitoring parameters.
Methodology: Patients who are prescribed chronic amiodarone therapy by a Carolinas HealthCare System Northeast (CHSNE) Sanger Heart and Vascular Institute (SHVI) cardiologist from January 2016 to August 2017 were included in the study. Patients received prospective AMS intervention from October 2017 until end of data collection in March 2018. Patient medical records were reviewed for the identification of due or overdue monitoring, lab work, imaging, or organ function tests. Subjects were contacted by phone call to schedule their laboratory tests and/or imaging, and to assess medication adherence and adverse effects. _x000D_ A _x001C_percent monitoring compliance score_x001D_ was given to each patient in the study before and after AMS intervention. The scoring tool was constructed as percent of monitoring parameters obtained. This served as the primary endpoint and was compared pre-and post-AMS service implementation. Secondary endpoints included rates of adverse events, patient adherence, and proper dosing for indication.
Presentation Objective: Describe the benefits of a pharmacist-led amiodarone monitoring service in an outpatient cardiology practice.
Self-Assessment: What are effective pharmacist-led services and strategies to improve adherence to monitoring parameters for patients taking chronic amiodarone therapy?
