Objective To investigate the intervention effect of clinical pharmacists using clinical pathway of antithrombotic drug therapy in the perioperative period for patients with cardiovascular and cerebrovascular diseases.

Methods The surgical inpatients with cardiovascular and cerebrovascular diseases from October 2019 to September 2020 were the conventional therapy group, and the inpatients from October 2020 to September 2021 were the pharmacist intervention group. The clinical pharmacists intervened the patients' medication regimen according to the clinical pathway, and continued to follow up until the patients were discharged from the hospital. The incidence of appropriate use of antithrombotic drugs during perioperative period, incidence of adverse durg events, length of hospital stays, readmission rate within 3 months after discharge, and total ex-penditure during hospitalization were compared and analyzed between the two groups of patients.

Results 121 patients were included in the conventional therapy group, and 202 patients were included in the pharmacist intervention group. There were no significant differences in the incidence of cardiovascular and cerebrovascular events (5.0% vs. 5.0%), venous thromboembolism (2.5% vs. 3.0%) and bleeding events (3.3% vs. 2.0%) be-tween the two groups (P>0.05). The proportion of all kinds of appropriate use of antithrombotic drugs during perioperative period (preoperative antiplatelet therapy 61.9% vs. 24.0% , preoperative anticoagulant therapy 66.3% vs. 39.7%, postoperative antiplatelet therapy 80.7% vs. 10.0%, postoperative anticoagulant therapy 89.6% vs. 65.3%, P<0.001), duration of hospitalization (13.00 days vs. 10.00 days, P=0.004), cost of western medicine during hospitalization (2 692.97 yuan vs. 2 110.76 yuan, P=0.008), cost of anticoagulant drugs during hospitalization (406.20 yuan vs. 200.28 yuan, P<0.001) in pharmacist intervention group were significantly lower than those in conventional therapy group.

Conclusion The establishment and application of clinical pathway of antithrombotic therapy in the perioperative period for patients with cardiovascular and cerebrovas-cular diseases may significantly improve the inappropriate use of antithrombotic drugs during the perioperative period, and effectively alleviate the economic burden of patients without increasing the incidence of adverse events.

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