Evaluating the role of a hospital pharmacist in a cardiac day ward.

Objectives: To evaluate the role of clinical pharmacists in cardiac day wards.

Methods: A service evaluation was conducted during 24 February 2020-27 March 2020 to assess the role of clinical pharmacists for all patients admitted to an Australian tertiary hospital cardiac day ward.

Key Findings: Overall, 297 patients were included. Medication review occurred for 80% (237/297) and a best possible medication history was obtained for 65% (193/297) of patients. Acceptance of interventions for medication-related problems was 93% (84/90). When compared with medication plans outlined in standard catheterisation laboratory documentation without pharmacist input, a pharmacist medication review resulted in increased documentation of medication plans in the patient's medical record at the time of discharge (20% (1/5) versus 95% (142/150), P < 0.001).

Conclusion: Pharmacists can optimise the medication management of patients in cardiac day wards by performing medication review, and facilitating implementation and communication of medication changes at hospital discharge to patients and primary healthcare providers.