Skip to main content

Advertisement

SpringerLink
Log in

Role of the Pharmacist for Improving Self-care and Outcomes in Heart Failure

  • Self-Care and Health Outcomes (R Gallagher and R Clark, Section Editors)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review highlights the current and emerging approaches for the role of the pharmacist for improving self-care and outcomes in heart failure management.

Recent Findings

Pharmacists are contributing to heart failure management in a variety of settings, including hospitals, clinics, and communities. Different interventions which may be mediated by the pharmacist include drug adherence, discharge counseling, medication reconciliation, telephone follow-up, and recommendation of evidence-based medicines.

Summary

Pharmacist engagement in heart failure management has demonstrated improved drug adherence, readmission rates, medication management, self-care ability, patient satisfaction, and heart failure knowledge. Some findings are mixed, especially for readmission rates. Improved medication management was reported in nearly all studies, despite significant heterogeneity in the models of care, patient populations, and study designs. This review highlights the requirement for large randomized trials with extended follow-up to confirm the impact of the role of the pharmacist in HF self-care, particularly through multidisciplinary-based interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–200. doi:10.1093/eurheartj/ehw128. The very latest 2016 ESC guideline has explained the importance of self-care in HF.

    Article  PubMed  Google Scholar 

  2. Page K, Marwick TH, Lee R, Grenfell R, Abhayaratna WP, Aggarwal A, et al. A systematic approach to chronic heart failure care: a consensus statement. Med J Aust. 2014;201(3):146–50. doi:10.5694/mja14.00032.

    Article  PubMed  Google Scholar 

  3. Al-Khazaali A, Arora R, Helu HK. Effective strategies in reducing rehospitalizations in patients with heart failure. Am J Ther. 2016;23(3):e799–804. doi:10.1097/mjt.0000000000000065.

    Article  PubMed  Google Scholar 

  4. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33(14):1787–847. doi:10.1093/eurheartj/ehs104.

    Article  PubMed  Google Scholar 

  5. Jessup M, Marwick TH, Ponikowski P, Voors AA, Yancy CW. 2016 ESC and ACC/AHA/HFSA heart failure guideline update—what is new and why is it important? Nat Rev Cardiol. 2016;13(10):623–28. doi:10.1038/nrcardio.2016.134.

    Article  PubMed  Google Scholar 

  6. Inamdar AA, Inamdar AC. Heart failure: diagnosis, management and utilization. J Clin Med. 2016;5(7). doi:10.3390/jcm5070062.

  7. Blecker S, Paul M, Taksler G, Ogedegbe G, Katz S. Heart failure-associated hospitalizations in the United States. J Am Coll Cardiol. 2013;61(12):1259–67. doi:10.1016/j.jacc.2012.12.038.

    Article  PubMed  Google Scholar 

  8. Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6(3):606–19. doi:10.1161/HHF.0b013e318291329a.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Chong VH, Singh J, Parry H, Saunders J, Chowdhury F, Mancini DM, et al. Management of noncardiac comorbidities in chronic heart failure. Cardiovasc Ther. 2015;33(5):300–15. doi:10.1111/1755-5922.12141.

    Article  PubMed  Google Scholar 

  10. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29–322. doi:10.1161/cir.0000000000000152.

    Article  PubMed  Google Scholar 

  11. Mazurek JA, Jessup M. Understanding Heart Failure. Card Electrophysiol Clin. 2015/11/26 ed2015. p. 557-75. doi: 10.1016/j.ccep.2015.08.001.

  12. Loudon BL, Noordali H, Gollop ND, Frenneaux MP, Madhani M. Present and future pharmacotherapeutic agents in heart failure: an evolving paradigm. Br J Pharmacol. 2016;173(12):1911–24. doi:10.1111/bph.13480.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. van Riet EE, Hoes AW, Wagenaar KP, Limburg A, Landman MA, Rutten FH. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail. 2016;18(3):242–52. doi:10.1002/ejhf.483.

    Article  PubMed  Google Scholar 

  14. Chan YK, Tuttle C, Ball J, Teng TK, Ahamed Y, Carrington MJ, et al. Current and projected burden of heart failure in the Australian adult population: a substantive but still ill-defined major health issue. BMC Health Serv Res. 2016;16(1):501. doi:10.1186/s12913-016-1748-0.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Liu L, Eisen HJ. Epidemiology of heart failure and scope of the problem. Cardiol Clin. 2014;32(1):1–8. doi:10.1016/j.ccl.2013.09.009. vii.

    Article  CAS  PubMed  Google Scholar 

  16. Ziaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol. 2016;13(6):368–78. doi:10.1038/nrcardio.2016.25.

    Article  PubMed  Google Scholar 

  17. Jaarsma T, Stromberg A, Martensson J, Dracup K. Development and testing of the European Heart Failure Self-Care Behaviour Scale. Eur J Heart Fail. 2003;5(3):363–70. doi:10.1016/S1388-9842(02)00253-2.

    Article  CAS  PubMed  Google Scholar 

  18. Riegel B, Carlson B, Moser DK, Sebern M, Hicks FD, Roland V. Psychometric testing of the self-care of heart failure index. J Card Fail. 2004;10(4):350–60.

    Article  PubMed  Google Scholar 

  19. Jaarsma T, Arestedt KF, Martensson J, Dracup K, Stromberg A. The European Heart Failure Self-care Behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument. Eur J Heart Fail. 2009;11(1):99–105. doi:10.1093/eurjhf/hfn007.

    Article  PubMed  Google Scholar 

  20. Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1–7.

    Article  PubMed  Google Scholar 

  21. Oosterom-Calo R, van Ballegooijen AJ, Terwee CB, te Velde SJ, Brouwer IA, Jaarsma T, et al. Determinants of heart failure self-care: a systematic literature review. Heart Fail Rev. 2012;17(3):367–85. doi:10.1007/s10741-011-9292-9.

    Article  CAS  PubMed  Google Scholar 

  22. Riegel B, Moser DK, Anker SD, Appel LJ, Dunbar SB, Grady KL, et al. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009;120(12):1141–63. doi:10.1161/circulationaha.109.192628.

    Article  PubMed  Google Scholar 

  23. Lainscak M, Blue L, Clark AL, Dahlstrom U, Dickstein K, Ekman I, et al. Self-care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2011;13(2):115–26. doi:10.1093/eurjhf/hfq219.

    Article  PubMed  Google Scholar 

  24. Jonkman NH, Schuurmans MJ, Groenwold RH, Hoes AW, Trappenburg JC. Identifying components of self-management interventions that improve health-related quality of life in chronically ill patients: Systematic review and meta-regression analysis. Patient Educ Couns. 2016;99(7):1087–98. doi:10.1016/j.pec.2016.01.022.

    Article  PubMed  Google Scholar 

  25. • Spaling MA, Currie K, Strachan PH, Harkness K, Clark AM. J Adv Nurs. 2015;71(11):2478–89. doi:10.1111/jan.12712. This systematic review explains the patients’ perspectives on self-care.

    Article  PubMed  Google Scholar 

  26. Harkness K, Spaling MA, Currie K, Strachan PH, Clark AM. A systematic review of patient heart failure self-care strategies. J Cardiovasc Nurs. 2015;30(2):121–35. doi:10.1097/jcn.0000000000000118.

    Article  PubMed  Google Scholar 

  27. •• Clark AM, Spaling M, Harkness K, Spiers J, Strachan PH, Thompson DR, et al. Determinants of effective heart failure self-care: a systematic review of patients’ and caregivers’ perceptions. Heart. 2014;100(9):716–21. doi:10.1136/heartjnl-2013-304852. This systematic review explains the the determinants of effectice self-care and importance of family memebrs in HF self-care.

    Article  PubMed  Google Scholar 

  28. Srisuk N, Cameron J, Ski CF, Thompson DR. Randomized controlled trial of family-based education for patients with heart failure and their carers. J Adv Nurs. 2016. doi:10.1111/jan.13192.

    PubMed  Google Scholar 

  29. Cameron J, Rhodes KL, Ski CF, Thompson DR. Carers’ views on patient self-care in chronic heart failure. J Clin Nurs. 2016;25(1-2):144–52. doi:10.1111/jocn.13124.

    Article  PubMed  Google Scholar 

  30. Jaarsma T, Stromberg A, Ben Gal T, Cameron J, Driscoll A, Duengen HD, et al. Comparison of self-care behaviors of heart failure patients in 15 countries worldwide. Patient Educ Couns. 2013;92(1):114–20. doi:10.1016/j.pec.2013.02.017.

    Article  PubMed  Google Scholar 

  31. Dickson VV, Buck H, Riegel B. Multiple comorbid conditions challenge heart failure self-care by decreasing self-efficacy. Nurs Res. 2013;62(1):2–9. doi:10.1097/NNR.0b013e31827337b3.

    Article  PubMed  Google Scholar 

  32. Buck HG, Dickson VV, Fida R, Riegel B, D’Agostino F, Alvaro R, et al. Predictors of hospitalization and quality of life in heart failure: a model of comorbidity, self-efficacy and self-care. Int J Nurs Stud. 2015;52(11):1714–22. doi:10.1016/j.ijnurstu.2015.06.018.

    Article  PubMed  Google Scholar 

  33. Gandhi J, McCue A, Cole R. Nonadherence in the advanced heart failure population. Curr Heart Fail Rep. 2016;13(2):77–85. doi:10.1007/s11897-016-0287-7.

    Article  PubMed  Google Scholar 

  34. Mastromarino V, Casenghi M, Testa M, Gabriele E, Coluccia R, Rubattu S, et al. Polypharmacy in heart failure patients. Curr Heart Fail Rep. 2014;11(2):212–19. doi:10.1007/s11897-014-0186-8.

    Article  PubMed  Google Scholar 

  35. Lambrinou E, Protopapas A, Kalogirou F. Educational challenges to the health care professional in heart failure care. Curr Heart Fail Rep. 2014;11(3):299–306. doi:10.1007/s11897-014-0203-y.

    Article  PubMed  Google Scholar 

  36. Krum H, Jelinek MV, Stewart S, Sindone A, Atherton JJ. 2011 update to National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand Guidelines for the prevention, detection and management of chronic heart failure in Australia, 2006. Med J Aust. 2011;194(8):405–9.

    PubMed  Google Scholar 

  37. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147–239. doi:10.1016/j.jacc.2013.05.019.

    Article  PubMed  Google Scholar 

  38. Riegel B, Lee CS, Dickson VV. Self care in patients with chronic heart failure. Nat Rev Cardiol. 2011;8(11):644–54. doi:10.1038/nrcardio.2011.95.

    Article  PubMed  Google Scholar 

  39. Jovicic A, Holroyd-Leduc JM, Straus SE. Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials. BMC Cardiovasc Disord. 2006;6:43. doi:10.1186/1471-2261-6-43.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Linn AC, Azollin K, Souza EN. Association between self-care and hospital readmissions of patients with heart failure. Rev Bras Enferm. 2016;69(3):500–6. doi:10.1590/0034-7167.2016690312i.

    Article  PubMed  Google Scholar 

  41. Wiggins BS, Rodgers JE, DiDomenico RJ, Cook AM, Page 2nd RL. Discharge counseling for patients with heart failure or myocardial infarction: a best practices model developed by members of the American College of Clinical Pharmacy’s Cardiology Practice and Research Network based on the Hospital to Home (H2H) Initiative. Pharmacotherapy. 2013;33(5):558–80. doi:10.1002/phar.1231.

    Article  PubMed  Google Scholar 

  42. Koshman SL, Charrois TL, Simpson SH, McAlister FA, Tsuyuki RT. Pharmacist care of patients with heart failure: a systematic review of randomized trials. Arch Intern Med. 2008;168(7):687–94. doi:10.1001/archinte.168.7.687.

    Article  PubMed  Google Scholar 

  43. Lowrie R, Mair FS, Greenlaw N, Forsyth P, Jhund PS, McConnachie A, et al. Pharmacist intervention in primary care to improve outcomes in patients with left ventricular systolic dysfunction. Eur Heart J. 2012;33(3):314–24. doi:10.1093/eurheartj/ehr433.

    Article  PubMed  Google Scholar 

  44. Eggink RN, Lenderink AW, Widdershoven JW, van den Bemt PM. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure. Pharm World Sci. 2010;32(6):759–66. doi:10.1007/s11096-010-9433-6.

    Article  PubMed  PubMed Central  Google Scholar 

  45. •• Kang JE, Han NY, Oh JM, Jin HK, Kim HA, Son IJ, et al. Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis. J Clin Pharm Ther. 2016;41(2):145–57. doi:10.1111/jcpt.12367. This is a latest systematic review on role of the pharmacist in HF and acute coronary syndrome.

    Article  CAS  PubMed  Google Scholar 

  46. •• Roblek T, Deticek A, Leskovar B, Suskovic S, Horvat M, Belic A, et al. Clinical-pharmacist intervention reduces clinically relevant drug-drug interactions in patients with heart failure: a randomized, double-blind, controlled trial. Int J Cardiol. 2016;203:647–52. doi:10.1016/j.ijcard.2015.10.206. It is a latest randomized, double-blind, controlled trial to explain about the role of clinical pharmacist in reduction of drug-drug interactions.

    Article  PubMed  Google Scholar 

  47. Fera T, Anderson C, Kanel KT, Ramusivich DL. Role of a care transition pharmacist in a primary care resource center. Am J Health Syst Pharm. 2014;71(18):1585–90. doi:10.2146/ajhp130684.

    Article  PubMed  Google Scholar 

  48. Shepherd MR, Thomas D, Herald M, Adane ED. Evaluation of a pharmacist-managed heart failure education project. J Pharm Technol. 2015;31(3):120–6. doi:10.1177/8755122514563177.

    Article  CAS  Google Scholar 

  49. Martinez AS, Saef J, Paszczuk A, Bhatt-Chugani H. Implementation of a pharmacist-managed heart failure medication titration clinic. Am J Health Syst Pharm. 2013;70(12):1070–76. doi:10.2146/ajhp120267.

    Article  PubMed  Google Scholar 

  50. Kinugasa Y, Kato M, Sugihara S, Yanagihara K, Yamada K, Hirai M, et al. Multidisciplinary intensive education in the hospital improves outcomes for hospitalized heart failure patients in a Japanese rural setting. BMC Health Serv Res. 2014;14:351. doi:10.1186/1472-6963-14-351.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Bos-Touwen I, Jonkman N, Westland H, Schuurmans M, Rutten F, de Wit N, et al. Tailoring of self-management interventions in patients with heart failure. Curr Heart Fail Rep. 2015;12(3):223–35. doi:10.1007/s11897-015-0259-3.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kalista T, Lemay V, Cohen L. Postdischarge community pharmacist-provided home services for patients after hospitalization for heart failure. J Am Pharm Assoc (2003). 2015;55(4):438–42. doi:10.1331/JAPhA.2015.14235.

    Article  Google Scholar 

  53. Albert NM. A systematic review of transitional-care strategies to reduce rehospitalization in patients with heart failure. Heart Lung: J Acute Crit Care. 2016;45(2):100–13. doi:10.1016/j.hrtlng.2015.12.001.

    Article  Google Scholar 

  54. • Lowrie R, Johansson L, Forsyth P, Bryce SL, McKellar S, Fitzgerald N. Experiences of a community pharmacy service to support adherence and self-management in chronic heart failure. Int J Clin Pharm. 2014;36(1):154–62. doi:10.1007/s11096-013-9889-2. This study explains the role of community pharmacist in HF self-care.

    Article  PubMed  Google Scholar 

  55. •• Davis EM, Packard KA, Jackevicius CA. The pharmacist role in predicting and improving medication adherence in heart failure patients. J Manag Care Spec Pharm. 2014;20(7):741–55. doi:10.18553/jmcp.2014.20.7.741. This is a review paper to summarize the role of pharmacist in drug adherence.

    PubMed  Google Scholar 

  56. Szkiladz A, Carey K, Ackerbauer K, Heelon M, Friderici J, Kopcza K. Impact of pharmacy student and resident-led discharge counseling on heart failure patients. J Pharm Pract. 2013;26(6):574–79. doi:10.1177/0897190013491768.

    Article  PubMed  Google Scholar 

  57. Warden BA, Freels JP, Furuno JP, Mackay J. Pharmacy-managed program for providing education and discharge instructions for patients with heart failure. Am J Health Syst Pharm. 2014;71(2):134–39. doi:10.2146/ajhp130103.

    Article  PubMed  Google Scholar 

  58. Anderegg SV, Wilkinson ST, Couldry RJ, Grauer DW, Howser E. Effects of a hospitalwide pharmacy practice model change on readmission and return to emergency department rates. Am J Health Syst Pharm. 2014;71(17):1469–79. doi:10.2146/ajhp130686.

    Article  PubMed  Google Scholar 

  59. Andhuvan G, Venkatachalam VV, Sankar V. Impact of pharmacist education on medication adherance in heart failure patients. Int J Pharm Pharm Sci. 2014;6(11):474–76.

    Google Scholar 

  60. Truong JT, Backes AC. The impact of a continuum of care resident pharmacist on heart failure readmissions and discharge instructions at a community hospital. SAGE Open Med. 2015;3:2050312115577986. doi:10.1177/2050312115577986.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Vinluan CM, Wittman D, Morisky D. Effect of pharmacist discharge counselling on medication adherence in elderly heart failure patients: a pilot study. J Pharm Health Serv Res. 2015;6(2):103–10. doi:10.1111/jphs.12093.

    Article  Google Scholar 

  62. Donaho EK, Hall AC, Gass JA, Elayda MA, Lee VV, Paire S, et al. Protocol-driven allied health post-discharge transition clinic to reduce hospital readmissions in heart failure. J Am Heart Assoc. 2015;4(12):1–10. doi:10.1161/jaha.115.002296.

    Article  Google Scholar 

  63. Salas CM, Miyares MA. Implementing a pharmacy resident run transition of care service for heart failure patients: effect on readmission rates. Am J Health Syst Pharm. 2015;72(11 Suppl 1):S43–7. doi:10.2146/sp150012.

    Article  PubMed  Google Scholar 

  64. Jonkman NH, Westland H, Groenwold RH, Agren S, Anguita M, Blue L, et al. What are effective program characteristics of self-management interventions in patients with heart failure? An individual patient data meta-analysis. J Card Fail. 2016;22(11):861–71. doi:10.1016/j.cardfail.2016.06.422.

    Article  PubMed  Google Scholar 

  65. Ruppar TM, Cooper PS, Mehr DR, Delgado JM, Dunbar-Jacob JM. Medication adherence interventions improve heart failure mortality and readmission rates: systematic review and meta-analysis of controlled trials. J Am Heart Assoc. 2016;5(6). doi:10.1161/jaha.115.002606.

  66. Korajkic A, Poole SG, MacFarlane LM, Bergin PJ, Dooley MJ. Impact of a pharmacist intervention on ambulatory patients with heart failure: a randomised controlled study. J Pharm Pract Res. 2011;41(2):126–31.

    Article  Google Scholar 

  67. •• Ho TH, Caughey GE, Shakib S. Guideline compliance in chronic heart failure patients with multiple comorbid diseases: evaluation of an individualised multidisciplinary model of care. PLoS One. 2014;9(4):e93129. doi:10.1371/journal.pone.0093129. The pharmacist involved multidisciplinary team has role in recommendation of evidence-based medicines.

Download references

Acknowledgements

The authors would like to acknowledge the assistance of Mr. Peter Newman, Senior Librarian, Flinders University. Prof Robyn Clark is support by a Heart Foundation Future Leader Fellowship (APP100847-2016-2019).

Author information

Authors and Affiliations

  1. School of Nursing and Midwifery, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia

    Daya Ram Parajuli, Julie Franzon & Robyn A Clark

  2. Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, South Australia, Australia

    Ross A. McKinnon

  3. Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Sepehr Shakib

Authors
  1. Daya Ram Parajuli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie Franzon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ross A. McKinnon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sepehr Shakib
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robyn A Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daya Ram Parajuli.

Ethics declarations

Conflict of Interest

Daya Ram Parajuli, Julie Franzon, Ross A. McKinnon, Sepehr Shakib, and Robyn A Clark declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Self-Care and Health Outcomes

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Parajuli, D.R., Franzon, J., McKinnon, R.A. et al. Role of the Pharmacist for Improving Self-care and Outcomes in Heart Failure. Curr Heart Fail Rep 14, 78–86 (2017). https://doi.org/10.1007/s11897-017-0323-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11897-017-0323-2

Keywords

Search

Navigation