Impact of a cardiology pharmacist‐led intervention on high‐intensity statin prescribing upon discharge after acute myocardial infarction

Introduction Standard of care after an acute myocardial infarction (AMI) includes high-intensity statin therapy to lower the risk of future cardiovascular events. However, the use of high-intensity statins post-AMI remains suboptimal, presenting an opportunity for clinical pharmacist services to improve clinical care. Objective To evaluate the impact of a cardiology clinical pharmacist intervention upon the rate of high-intensity statins issued at hospital discharge after AMI. Methods This was a single-center, pre-post study that included patients 18 to 75 years of age who were discharged from one investigative site with a primary diagnosis of AMI (as determined by ICD-10 codes) between July 2019 to December 2020. The primary outcome was the proportion of patients prescribed high-intensity statins, defined as atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg daily, at discharge pre and postimplementation of a cardiology clinical pharmacist intervention. Patients were stratified into two groups for comparison: pre- (07/01/2019-3/31/2020) and post- (04/01/2020-12/31/2020) intervention, for which the latter included cardiology pharmacist-driven communication and documentation via the electronic health record. Results A total of 418 patients were included: 223 (53.3%) preintervention and 195 (46.7%) postintervention. The overall cohort was approximately two-thirds men and 90% Caucasian, with a mean +/- SD age of 61.4 +/- 9.7 years; the pre and postintervention groups were similar in terms of demographics. The rate of high-intensity statin prescribing at discharge improved from 83.0% preintervention to 95.4% postintervention (P <.0001). A total of 9.9%, 1.8%, and 5.4% of patients in the preintervention group received moderate-intensity, low-intensity, or no statin at discharge, respectively, lowering to 3.1%, 1.0%, and 0.5% postintervention. Conclusion There was a statistically significant increase in the rate of high-intensity statin prescribing post-AMI after the implementation of targeted cardiology clinical pharmacist services.