Impact of Continuous Pharmaceutical Care by a Collaborative Pharmacy Team on Reducing Drug-Related Problems in Coronary Heart Disease Patients: A Randomized Controlled Trial in an Integrated Healthcare System

Abstract Aims Building upon continuous pharmaceutical care (CPC) models led solely by clinical pharmacists, this study evaluated a collaborative pharmacy team model for reducing drug-related problems (DRPs) in coronary heart disease (CHD) patients during care transitions. Methods and results In a randomized controlled trial, 60 hospitalized CHD patients were allocated equally to a CPC group or a usual-care control group. The CPC group received structured pharmaceutical interventions in which clinical pharmacists led hospital care and community pharmacists led post-discharge care during key care transition periods: within 24 hours of admission (T0), 24 hour pre-discharge (T1), 24-72 hour post-discharge (T2), and at 1-month follow-up (T3). DRPs were identified using the Pharmaceutical Care Network Europe (PCNE) classification. Mean DRPs per patient were comparable at T0 (Control: 3.03 ± 1.16 vs. CPC: 3.10 ± 1.24; p = 0.827). Subsequently, the CPC group showed significantly fewer DRPs than the control group at T1 (0.17 ± 0.59 vs. 2.13 ± 1.04), T2 (0.03 ± 0.18 vs. 1.97 ± 1.03), and T3 (0.67 ± 0.76 vs. 2.63 ± 1.13) (all p < 0.001). Pharmacist interventions in the CPC group had a high DRP acceptance rate 91.4% (181/198) and a resolution rate 89.1% (106/119). At 1-month follow-up, the CPC group demonstrated superior outcomes compared to the control group: LDL-C goal attainment (63.3% vs. 30.0%, p = 0.010), medication adherence (90.0% vs. 66.7%, p = 0.028), patient satisfaction (Numeric Rating Scale: 9.27 ± 0.52 vs. 8.59 ± 0.52, p < 0.001), and willingness to pay for pharmaceutical services (86.7% vs. 50.0%, p = 0.002). Conclusion This collaborative pharmacy team model effectively reduced DRPs and improved lipid control and patient-reported outcomes in CHD patients, offering a scalable approach for integrated healthcare systems. Registered at the Chinese Clinical Trial Registry on July 1, 2024 (Registration number: ChiCTR2400086416; URL: https://www.chictr.org.cn/bin/project/edit?pid=235446).