Letter reporting a review of clinical pharmacist involvement in the multidisciplinary care of patients with left ventricular assist devices (LVADs) at a large, urban, tertiary care centre in the Midwest of the USA.  All patients subsequently admitted to the Cardiothoracic Surgery (CTS) service who received an LVAD from 1 Jul 2009 to 30 Jun 2010 were eligible for inclusion in this project, as were ambulatory patients with LVADs who were readmitted to the Advanced Heart Failure (AHF) service.

During the data collection period, 30 patients were admitted to the CTS service and 32 were admitted to the AHF service (71% male, 58% white).  Because some of the ambulatory patients with LVADs were readmitted more than once, the total number of encounters in the AHF service was 75.  The clinical pharmacist documented 400 interventions in patients with LVADs (262 interventions on the CTS service, average 8.7 interventions per patient encounter; 138 interventions on the AHF service, average 1.8 interventions per patient encounter).  Overall, the most common type of pharmacist intervention was change in dose/route/frequency (33%), followed by starting therapy (31%), discontinuing therapy (18%), ordering a laboratory test (12%) and changing therapy (6%). The most common reason for pharmacist intervention was treatment of a disease or condition that was not controlled on present therapy (36%), followed by dose correction (17%), improved monitoring of drug therapy (13%) and adverse drug reaction/drug-drug interaction (11%).  Antimicrobial agents was the most frequent medication class involved in pharmacist intervention.