Abstract 256: The Effect Of Credentialed Cardiovascular Pharmacists On Process Measures And Outcomes In Myocardial Infarction And Heart Failure

Abstract

Background: Although cardiology pharmacist credentialing is strongly advocated, there is little to no evidence suggesting board certification improves patient outcomes. The purpose of this study is to determine if institutions with inpatient cardiology credentialed pharmacists exhibit improved quality measure performance for myocardial infarction and heart failure compared to institutions without inpatient cardiology credentialed pharmacists. Methods: This is a multicenter, retrospective, cross-sectional, matched case-control study. The cardiology credentialing studied was the Board of Pharmaceutical Specialties (BPS) Added Qualification in Cardiology (AQCV). A list of AQCV pharmacists was derived from publically available data on the BPS website in July 2011 for inclusion in the study. Each case AQCV pharmacist hospital was matched to a hospital without an AQCV pharmacist in a 1 to 3 manner. Control hospitals were matched by geographical region, number of cardiovascular discharges, and the type of hospital. The proportion of patients meeting HF and AMI process of care measures, 30-day readmission rate, and 30 day mortality for each hospital were determined from the website Hospital Compare. Results: The 34 AQCV hospitals were matched to 102 non-AQCV hospitals. Hospitals that employed inpatient AQCV pharmacists performed better on a composite of 5 medication-related process of care measures compared to hospitals that do not employ inpatient AQCV pharmacists (OR 1.41, 95% CI 1.25-1.58, p <0.0001, p<0.001 for heterogeneity). The individual measures that were improved were aspirin on discharge for AMI and ACEi/ARB on discharge for HF. Thirty day readmission and mortality for HF and AMI were not different in hospitals that employed inpatient AQCV pharmacists compared to those that do not. Conclusions: Hospitals that employ inpatient AQCV credentialed pharmacists have improved performance on process of care measures compared to those that do not employ AQCV credentialed pharmacists. This analysis did not demonstrate that inpatient AQCV credentialed pharmacists improve readmissions or mortality for AMI and HF.