Purpose: The aim of this paper is to assess the impact of cardiac rehabilitation through a systematic review comparing cardiac rehabilitation to pharmacological treatment assessing the benefits and risks associated with it. Through examining cardiac rehabilitation, this dissertation clarifies the importance behind such strategies by summarising the evidence of benefit. Method: The types of evidence used for this research include both primary and secondary sources. The question of the effectiveness of cardiac rehabilitation is addressed by arguing that if the implementation of cardiac rehabilitation were improved the benefits would be higher. This study combines the findings of several studies to draw reliable conclusions supported by evidence than the component studies alone. Findings: Considering the evidence, area‟s, which require questioning, include the introduction of an online programme for patients to conduct the programme in the comfort of their own home compensating for the time used when attending appointments. Other areas include educating patients on the benefits of cardiac rehabilitation to motivate patients to attend. Conclusion: Despite the evidence, cardiac rehabilitation remains questioned; areas that require exposal include improving attendance, referral rates and introducing new areas of delivery.

Since the year 2000, the world elderly population increased by 48%. Medical problems become more predominant with aging leading to polypharmacy. Biological changes can occur with aging resulting in increased susceptibility of older people to medications and their side effects. These changes may have greater effect in a frail person or person with number or long-term or chronic diseases and conditions. Atorvastatin, rosuvastatin, perindopril, amlodipine and paracetamol are commonly used medications among elderly. This paper has reviewed clinical trials and publications on these medications among elderly. It has been found that the safety and effectiveness of these medications among elderly had been evaluated with the main focus on the effectiveness of these medications on different medical conditions and less focus on the effects of the elderly pharmacokinetics and pharmacodynamic changes on these medications. Thus, more clinical trials are required to test elderly biological changes’ effects on these medications.

The Prescribers Survey Report 2016 identified 3,944 annotated pharmacist prescribers on the General Pharmaceutical Council register in 2015 with 2,567 independent prescribers, 425 are supplementary prescribers and 952 are both. This survey-based study evaluated the perceptions of University of Wolverhampton Master of Pharmacy students about pharmacist independent prescribing. Ethics clearance was granted by the School of Pharmacy Ethics Board. A link to an online survey was sent to all students enrolled in the Master of Pharmacy course. The anonymous data analysed thematically. Cohort-dependant variations were identified, with Year 1 and 2 students more informed about independent prescribing and including it in their career plans. Students in Year 3 and 4 were more likely to pursue the career if it was appealing after graduation. This may be due to the course workload in Year 3 and 4 plus another year of internship, making further study unappealing at that time.

<jats:p>This review aims to understand the co-existence of mental ill-health and heart failure and if this comorbidity affects patient self-care motivation and overall health outcomes. Databases searched were; PubMed®, Google® scholar and Science Direct® for studies related to heart failure, heart failure and mental health, depression and anxiety. Eleven articles were identified and reviewed. There were two studies disagreed with the theory that the mental ill-health and heart failure has disease modification and worsen patient health outcomes, three studies concluded that only anxiety has effect, five studies concluded that both anxiety and depression have effect, six studies concluded that depression only has effect but all eleven stated that more research is required. Recent theories on depression and cardiovascular disease comorbidity and the effect mental ill-health have on medication adherence in heart failure patients was discussed. People with long-term physical illnesses may suffer further complications to their health if they develop mental illness; increasing the cost of their care by an average of 45%, however, in the majority of these cases, the mental issues neither diagnosed nor treated. This review explored the link between cardiovascular disease (CVD) and mental ill health; and how comorbidity of the two conditions affects patients’ adherence to therapy behaviour. It was concluded that while the link between mental ill health and heart failure (HF) is recognized, studies that may be used as a basis of evidence to confirm this link are scarce.</jats:p>