Assessment of Clinical Pharmacists' Assistance for Patients With Established Cardiovascular Diseases During the COVID-19 Pandemic: Insights From Southern India

Objectives: We aimed to assess the impact of clinical pharmacist-initiated telephone-based patient education and self-management assistance for patients with cardiovascular disease during the nationwide lockdown during COVID -19 pandemic. Methods: A prospective single-centre telephone-based cross-sectional study was conducted among patients at the Cardiology Department and its speciality clinic at a 1,800-bed tertiary care hospital in Southern India. A validated 8-item clinical pharmacist aided on-call questionnaire with two Domains was administered during and after lockdown (15 March and 8 June 2020). Clinical pharmacist-provided educational assistance on self-management practices were in accordance with the guidelines of Indian Council of Medical Research (ICMR) and World Health Organisation. Comparisons was performed using sign test and association of responses were analyzed using the Goodman and Kruskal's gamma test. All the tests were two-tailed, p-value < 0.05 was considered to be statistically significant. Results: Of the 1080 patients, 907 consented with a response rate of (83.9%) and 574 (96.36%) patients were analysed post-intervention. Majority of the patients were male (54.7 %) and had Acute Coronary Syndrome [NSTEMI (42.10%), STEMI (33.92 %) and UA (9.86)]. The majority of subjects had at least two co-morbid conditions [(T2DM (48.33 %), HTN (50.11 %)] and were rural population (82.5%) as self-employed (43.1%) with a middle-class economy (31.6%). In the Domain-1 of checklist the awareness towards complications caused by COVID-19 in cardiovascular diseases and the importance of universal safety precautions enhanced after clinical pharmacist assistance [(Z= -8.603, p<0.000) and (Z= -21.795, p<0.000)]. In Domain-II of checklist there was a significant improvement in patients awareness towards fatal complications caused by COVID-19 (Z= -20.543, p<0.000), maintenance of self-hygiene (Z= -19.287, p<0.000), practice of universal safety precautions (Z= -16.912, p<0.000) and self-isolation (Z=-19.545, p<0.000).The results of our study population varied from baseline evaluation (41.7%, n=907) to post-intervention (95%, n=574) based on Literacy, employment status and economic status . Conclusions: The proactive role of clinical pharmacists in providing instructional services in collaboration with cardiologist during the pandemic circumstances increased patients understanding and mitigated infection exposure among patients, health care professionals and also assuring the continuity of care in patients with established cardiovascular diseases.