PMID- 35813573
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220718
IS  - 2574-9870 (Electronic)
IS  - 2574-9870 (Linking)
VI  - 5
IP  - 4
DP  - 2022 Apr
TI  - Pharmacists as members of an interdisciplinary pulmonary embolism response team.
PG  - 390-397
LID - 10.1002/jac5.1569 [doi]
AB  - INTRODUCTION: Pulmonary embolism response teams (PERTs) were developed to assist 
      with diagnosis, risk stratification, and management of intermediate and high-risk 
      pulmonary embolism (PE) and have been shown to reduce 90-day mortality. The 
      pharmacist's role on the PERT is not well defined. OBJECTIVES: Describe the 
      pharmacist's role as a PERT member and determine if pharmacists can improve time 
      to anticoagulation and promote use of low molecular weight heparin (LMWH) instead 
      of unfractionated heparin (UFH). METHODS: A retrospective, observational study of 
      adult patients with massive or submassive PE between January 2014 and May 2020. 
      Patient demographics, clinical variables, anticoagulation treatment/timing, and 
      pharmacist activities during PERT response were evaluated. Patients were divided 
      into three groups for comparisons (pre-PERT vs post-PERT with a pharmacist vs 
      post-PERT without a pharmacist). Wilcoxon rank-sum or Kruskal-Wallis test and 
      chi-squared analysis were used for continuous and categorical data, respectively. 
      RESULTS: A total of 573 patients were included (mean age 63.2 +/- 15.6 years, 54% 
      male, 78% submassive PE); 137 in the pre-PERT and 436 in the post-PERT groups. 
      Within the post-PERT group, 305 patients (70%) had a pharmacist as a member of 
      the PERT, of which 222 (73%) had a documented pharmacotherapy-related 
      intervention/activity. Most (n = 178, 58%) involved a pharmacist facilitating 
      ordering/administration of an anticoagulant/thrombolytic. Median time from 
      diagnosis to anticoagulation was significantly reduced in the post-PERT groups 
      (pre-PERT: 104 minutes [IQR 124.5], post-PERT with a pharmacist: 63 minutes [IQR 
      84], post-PERT without a pharmacist: 75.5 minutes [IQR 113], P = .0001). More 
      patients in the post-PERT groups received LMWH compared to UFH when a pharmacist 
      was involved vs without a pharmacist (69.5% vs 53.3%, P = .0019) and major 
      bleeding events were reduced (pre-PERT: 14.6%, post-PERT with a pharmacist: 4.6%, 
      and post-PERT without a pharmacist: 9.9%, P = .0013). CONCLUSION: Pharmacists 
      have an active role on the PERT and their involvement was associated with a 
      shorter diagnosis to anticoagulation time, increased LMWH use, and fewer major 
      bleeding events.
FAU - Groth, Christine M
AU  - Groth CM
AUID- ORCID: 0000-0001-7419-5312
AD  - Department of Pharmacy, University of Rochester Medical Center, Rochester, New 
      York, USA.
FAU - Acquisto, Nicole M
AU  - Acquisto NM
AUID- ORCID: 0000-0002-7649-9624
AD  - Department of Pharmacy and Emergency Medicine, University of Rochester Medical 
      Center, Rochester, New York, USA.
FAU - Wright, Colin
AU  - Wright C
AD  - Department of Medicine, Highland Hospital, Rochester, New York, USA.
AD  - Department of Interventional Cardiology, St. Elizabeth Hospital, Utica, New York, 
      USA.
FAU - Marinescu, Mark
AU  - Marinescu M
AD  - Department of Medicine, Cardiology, University of Rochester Medical Center, 
      Rochester, New York, USA.
FAU - McNitt, Scott
AU  - McNitt S
AD  - Department of Medicine, Cardiology Heart Research, University of Rochester 
      Medical Center, Rochester, New York, USA.
FAU - Goldenberg, Ilan
AU  - Goldenberg I
AD  - Department of Medicine, Cardiology Heart Research, University of Rochester 
      Medical Center, Rochester, New York, USA.
FAU - Cameron, Scott J
AU  - Cameron SJ
AD  - Department of Medicine, Cardiology, University of Rochester Medical Center, 
      Rochester, New York, USA.
AD  - Heart, Thoracic, and Vascular Institute, Department of Cardiovascular Medicine, 
      Cleveland Clinic Foundation, Cleveland, Ohio, USA.
LA  - eng
GR  - K08 HL128856/HL/NHLBI NIH HHS/United States
GR  - R01 HL158801/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20211122
PL  - United States
TA  - J Am Coll Clin Pharm
JT  - Journal of the American College of Clinical Pharmacy : JACCP
JID - 101723133
PMC - PMC9269076
MID - NIHMS1767849
OTO - NOTNLM
OT  - Human
OT  - interdisciplinary studies
OT  - pharmacists
OT  - pulmonary embolism
COIS- CONFLICT OF INTEREST The authors declare no conflicts of interest.
EDAT- 2022/07/12 06:00
MHDA- 2022/07/12 06:01
PMCR- 2022/07/08
CRDT- 2022/07/11 04:04
PHST- 2022/07/11 04:04 [entrez]
PHST- 2022/07/12 06:00 [pubmed]
PHST- 2022/07/12 06:01 [medline]
PHST- 2022/07/08 00:00 [pmc-release]
AID - 10.1002/jac5.1569 [doi]
PST - ppublish
SO  - J Am Coll Clin Pharm. 2022 Apr;5(4):390-397. doi: 10.1002/jac5.1569. Epub 2021 
      Nov 22.