Cardiology patients with complicated medication regimens often have poor medication adherence, struggle to meet healthcare goals,and pose a potential increased financial and workflow burden on cardiology clinics. We propose to integrate community pharmacy expertise to attain patient-related safety and adherence goals through in-home medication management training. Our goal is to positively influence patient-related medication and therapeutic goals through a collaboration with Kelley-Ross Clinical Pharmacy Institute and Virginia Mason Medical Center. Through a referral process, patients will be identified by Virginia Mason cardiology staff and referred to the service. Following referral, Kelley-Ross will coordinate in-home visits with the patient as well as telephonic follow-up. Kelley-Ross will provide patients with intensive in-home training that will involve four pharmacist-led interventions: Identification and resolution of medication-related problems and medication discrepancies, provision of patient-centered goal setting and education, referral to additional care as appropriate, and facilitation of follow-up with cardiology clinic or primary care physician. We will analyze the overall effects of this program on number of all cause admissions, 30-day and 90-day readmissions, number of ER visits, quality of life, cost analyses including cost of service, medication costs, clinic costs, and hospital costs, as well as various process, medication, and clinic specific metrics.