Community Pharmacy Involvement in Cardiovascular Patient Follow-Up: A Conceptual Framework for Integrated Ambulatory Pharmaceutical Care

Background/Objectives: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, requiring coordinated long-term management of cardiovascular risk factors, complex pharmacotherapy, and continuity of care across healthcare settings. Community pharmacists are well-placed to support ambulatory cardiovascular care; however, their contribution often remains insufficiently integrated into cardiovascular care pathways, limiting continuity, information exchange, and coordinated medication management across community, primary, and specialist care. This study aimed to establish the scientific basis for the development of an Integrated Ambulatory Pharmaceutical Follow-Up Programme in Cardiology by synthesising the available evidence on pharmacist-led cardiovascular care. Methods: An evidence-informed narrative synthesis was conducted using targeted searches of PubMed/MEDLINE, Scopus, and Web of Science, complemented by manual screening of reference lists. Priority was given to systematic reviews, meta-analyses, randomised controlled trials, and high-quality observational studies addressing pharmacist-led interventions in cardiovascular risk management, heart failure, transitions of care, cardiac rehabilitation, and integrated pharmaceutical care. Evidence was mapped across clinical outcomes, care processes, professional roles, and implementation requirements and subsequently translated into the components of the proposed integrated ambulatory care framework. Results: The available evidence consistently indicates that pharmacist-led interventions improve cardiovascular risk factor control, medication adherence, pharmacotherapy optimisation, and patient-reported outcomes. Community pharmacies provide accessible and effective settings for cardiovascular risk screening, chronic disease monitoring, and structured follow-up. In heart failure, pharmacist involvement supports optimisation of guideline-directed medical therapy, while during care transitions it contributes to the identification and reduction in medication-related problems. In cardiac rehabilitation and secondary prevention, pharmacist-led care supports medication optimisation, adherence, and cardiovascular risk-factor management. Overall, the available evidence supports the integration of community pharmacists into multidisciplinary ambulatory cardiovascular care pathways and provides the evidence base for the proposed conceptual framework. Conclusions: The proposed Integrated Ambulatory Pharmaceutical Follow-Up Programme in Cardiology provides an evidence-informed conceptual framework to support the structured integration of community pharmacists into ambulatory cardiovascular care. Its implementation has the potential to strengthen continuity of care, optimise pharmacotherapy, and support improved cardiovascular outcomes when supported by collaborative practice models, interoperable health information systems, and appropriate organisational frameworks.