A Qualitative Study of the Contribution of Pharmacists to Heart Failure Management in Scotland
- 145 Downloads
(1) To identify the medication management needs of chronic heart failure (CHF) patients and their caregivers; (2) To examine the perceived support for medication management available to these people from health professionals; (3) To identify the actual and potential perceived contribution of pharmacists to medication management.
A mixed urban/ rural region in the west of Scotland.
Semi-structured qualitative research interviews.
A total of 50 people with CHF (NYHA Class II and III) due to left ventricular systolic dysfunction (33 males; mean age 67 years, 17 females; mean age 68 years) and 30 nominated caregivers recruited from the outpatient departments of two hospitals in the West of Scotland. Sampling was purposive to include patients from a range of CHF severity, ages and sexes.
Managing medications was a responsibility shared by both the patients with CHF and caregivers. Treatment regimens were reported to be difficult to comply with. Health professionals were seen to provide little support for medication management. Pharmacists were viewed as being a good and accessible source of practical assistance who were also knowledgeable about the individual’s heart health history. Participants reported valuing advice from pharmacists about the side effects of medications and for their assistance in reducing the complex logistics of medication management and in having medications delivered.
Patients with CHF and caregivers voiced a willingness to try to manage their medication regimen accurately but had a limited capacity to do so. Pharmacists were viewed as providing valuable support to patients with CHF and their caregivers, in terms of medication management. The extended role of pharmacists in medication management of CHF should be encouraged.
KeywordsConcordance Disease management Heart failure Medication Pharmacists Qualitative study Scotland Support
Unable to display preview. Download preview PDF.
- 1.BHF2002Coronary Heart Disease Statistics: Heart Failure SupplementBritish Heart Foundation. LondonISBN 1899088652Google Scholar
- 4.O’Connell, JB, Bristow, M 1993Economic impact of heart failure in the United States: time for a different approachJ Heart Lung Transplant13S107S112Google Scholar
- 7.Hunt, SA, Baker, DW, Chin, MH, Cinquegrani, MP, Feldman, AM, Francis, GS, et al. 2001ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary: a report of the American College of Cardiology/ American Heart Association Task Force on Practice GuidelinesCirculation10429963007PubMedGoogle Scholar
- 8.National Institute for Clinical Excellence2003Chronic Heart Failure: Management of Chronic Heart Failure in Adults in Primary and Secondary CareNICELondonISBN 184257-323-3Google Scholar
- 16.McAlister FA, Murphy NF, Simpson CR, Stewart S, MacIntyre K, Kirkpatrick M et al. Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study. BMJ 2004; 328: 1110Google Scholar
- 17.Silver, MA 1996Patient knowledge of fundamental in chronic heart failurePrevention Manage Congest Heart Failure21113Google Scholar
- 19.Varma, S, McElnay, J, Hughes, C 2001A qualitative assessment of health-related issues of importance in elderly congestive heart failure patientsJ Social Admin Pharm185966Google Scholar
- 20.Dept of Health2001The Expert Patient: A New Approach to Chronic Disease Management for the 21st centuryDOHLondonGoogle Scholar
- 22.Dept of Health2000Pharmacy in the Future Implementing the NHS Plan – a programme for Pharmacy in the National Health ServiceDept. of HealthLondonGoogle Scholar
- 23.Royal Pharmaceutical Society of Great Britain1997From Compliance to Concordance: Towards Shared Goals in Medicine TakingRPSLondonGoogle Scholar
- 24.Scottish Executive2001The Right Medicine, a Strategy for Pharmaceutical Care in ScotlandScottish ExecutiveEdinburghGoogle Scholar
- 25.Younis, WS, Campbell, S, Slack, MK 2001Pharmacists’ attitudes towards diabetes and their involvement in diabetes educationAnn Pharmacotherapy358415Google Scholar
- 26.Patel K, Sansgiry SS, Miller L. Pharmacist participation in home heart failure programs. Am J Health Syst Pharm 2003; 2259–60Google Scholar
- 28.Gattis, WA, Hasselblad, V, Whellan, DJ, O’conner, CM 2000Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacists in Heart Failure Assessment Recommendation and Monitoring (PHARM) StudyArch Intern Med159193945Google Scholar
- 29.Bouvy, M, Heerdink, E, Urquhart, J, Gobee, D, Hoes, A, Leufkens, H, et al. 2003Effect of a pharmacist-led intervention on diuretic compliance in heart failure patients: a randomized controlled studyJ Card Fail9481Google Scholar
- 32.Reid M, Clark AM, Murdoch DL, Morrison C, Capewell S, McMurray JV. Patients’ strategies for managing medication for chronic heart failure. Int J Card (in press)Google Scholar
- 34.World Health Organisation2003Adherence to Long-term Therapies: Evidence for ActionWHOGenevaGoogle Scholar
- 35.Carter, S, Taylor, D, Levenson, R 2003A Question of Choice –Compliance in Medication TakingMedicines PartnershipLondonGoogle Scholar