Streamlining Post-PCI Medication Access to Improve DAPT Adherence and Outcomes

简化PCI术后药物获取途径以提高双联抗血小板治疗依从性和疗效

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Abstract

BACKGROUND: Dual antiplatelet therapy after percutaneous coronary intervention (PCI) is essential to prevent stent thrombosis and improve outcomes. Barriers such as cost, insurance delays, limited patient understanding, and pharmacy availability can hinder timely initiation and adherence. Delays are common when community pharmacies do not stock certain P2Y12 inhibitors, particularly newer, higher cost agents such as ticagrelor. PROJECT RATIONALE: We sought to reduce these barriers by integrating hospital outpatient pharmacy services into post-PCI discharge planning for both inpatient and outpatient PCI. PROJECT SUMMARY: A multidisciplinary team routed P2Y12 inhibitor prescriptions to the hospital's outpatient pharmacy, enabling financial assistance, streamlined prior authorizations, and bedside delivery before discharge. In a 2-week preimplementation audit, 5 of 9 ticagrelor, 3 of 3 clopidogrel, and 9 of 10 prasugrel prescriptions sent externally were filled. At postimplementation, 99.1% of prescriptions were filled and delivered bedside. TAKE-HOME MESSAGE: Leveraging hospital pharmacy resources for outpatient PCI patients ensures timely access to dual antiplatelet therapy, improves adherence, and reduces adverse cardiovascular events.

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