The human heart is an organ that pumps blood throughout the body via the circulatory system, supplying oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The tissues of the body need a constant supply of nutrition in order to be active," said Dr Lawrence Phillips, a cardiologist at NYU Langone Medical Center in New York. "If the heart is not able to supply blood to the organs and tissues, they'll die."
The pharmacist, the
drug expert plays a relevant
role in primary and secondary prevention of cardiovascular diseases, mainly
through patient education and counselling, drug safety management,
medication review, monitoring
and reconciliation, detection and control of specific cardiovascular risk
factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes.
In addition to medication
dispensing, the pharmacist can provide more direct interventions (eg,
medication education and disease management), as a support to the physician’s
action, in order to improve medication adherence, to achieve the goals of
desired therapeutic outcomes and to improve safe medication use and humanistic
control. The direct pharmacist’s intervention in patients’ care, in alternative
to the conventional approach, has proved to favourably affect therapeutic and
safety outcomes in different diseases or conditions including diabetes,
dyslipidaemia, arterial hypertension, obesity, asthma or chronic obstructive
pulmonary disease, infective diseases (including influenza immunisation),
psychiatric conditions and osteoporosis prevention. A recent overview of systematic reviews has documented a positive impact on patients’ outcomes (blood pressure and haemoglobin A1c reduction) of clinical pharmacy services targeting specific cardiovascular conditions, such as hypertension or diabetes mellitus.
Patients with multiple risk factors for coronary disease: The effectiveness of the pharmacist’s intervention to reduce risk behaviours and risk factors for coronary heart disease such as smoking, alcoholism helped to manage the lipid levels.
Effectiveness of the pharmacist’s intervention in diverse cardiovascular conditions
Hypertension: Community pharmacies may represent the ideal site for implementing community-based self-screening to detect hypertension in the population
Dyslipidaemia: common interventions included education, followed by drug therapy recommendations and adherence –lead to the decrease in LDL cholesterol.
Diabetes: Wubben and Vivian performed a qualitative meta-analysis of 21 studies (9 randomised controlled studies, 1 controlled clinical trial and 11 cohort studies) including 3981 diabetics. All interventions involved additional visits by pharmacists with expanded roles to care for adult patients with diabetes. An overall improvement in haemoglobin A1c was observed in different settings and across multiple studies designs: the differences in change for haemoglobin A1c ranged from an increase of 0.2% to a decrease of 2.1%.Diabetes education (69% of cases, consisting of verbal instructions on diet, exercise, drug therapy and the disease itself) and medication dosage adjustment (61%) were the most frequently used interventions
Heart failure: A first systematic review was published by Ponniah et al and evaluated the prognostic impact of pharmacy services on post-discharge patients with heart failure: in six of the seven included studies positive outcomes, such as decreases in unplanned hospital readmissions, death rates and greater compliance and medication knowledge were demonstrated.
Pharmacy services for cardiovascular
prevention and management
Ø Educational
activities directed at patients
oPatient education and counselling
oDrug safety management
Ø Informative
activities directed at healthcare professionals
oDocumenting
adverse drug reactions occurring to the patient
oMonitoring
patient’s adherence to physician’s prescription
Ø Direct
intervention in a multidisciplinary team
o Collaborative
medication management (including drug
administration)
o Medication
review and dose adjustment or titration
o Medication
monitoring and reconciliation
o Definition
and application of disease management pathways and protocols
o Detection,
prevention or control of specific cardiovascular risk factors
Actionable tips you can do now to improve
your heart health
1.If you presently require heart
medications, develop memorably habits to consistently take your
medications as your physician has directed. Monitor your blood pressure
regularly, and get cholesterol screenings on a regular basis.
2.Get active. Just 10 minutes of
physical activity daily can lower your risk of having a heart attack
significantly. Aiming for 30 minutes a day lowers your risk even more. If you sit much of your day, take a
walk on your breaks, and possibly stand at your workstation part of your day if
possible.
3.Don’t wait until you’re older to address
heart health. High obesity rates, high blood pressure and type 2 diabetes are
happening at increased rates in our younger population, putting them at risk of heart disease earlier in life.
4.Let’s get personal. Watch your
stress level as it leads to heart disease. Practice deep breathing to
relieve stress, keep anger in check, and laugh more. Laughter helps your blood vessels to relax and
expand, keeping your heart working properly. Get enough sleep too, as it lowers
stress and your risk of heart disease.
5.Stop smoking. Smoking damages blood
vessels and can cause heart disease. Ask for help
if needed.
6.Maintain – or work toward – a
healthy weight with diet and exercise. Develop heart-healthy eating habits low
in trans-fat, saturated fat, added sugar, and sodium. As a rule of thumb fill
at least half your plate with vegetables and fruit, and pick low sodium options.
As Helen Keller said, ”The best and most beautiful things in the world cannot be seen or even touched- they must be felt with the heart”.
Let’s focus on the instructions given by the Pharmacist and other healthcare providers and protect our most vital organ –‘ THE HEART ’
Ms. ASHLEY ANN DILIP, PHARMD
FOURTH YEAR
ST JOSEPH’S COLLEGE OF PHARMACY,
CHERTHALA
(This Blog article secured first
prize for Blog writing competition conducted by College in association with
World heart day)
nicely written
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