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Evaluation of a pharmacist-led shared decision-making in atrial fibrillation and patients’ satisfaction—a before and after pilot study

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Abstract

Background

Chronic complex diseases like atrial fibrillation have potential long-term economical and personal consequences. Shared decision-making principles may promote therapeutic compliance, satisfaction and outcomes. Pharmacists, as patient-advocates, play a key role in guiding them through complex clinical decisions about their chronic disease management and anticoagulation choices.

Aim

To evaluate the impact of pharmacist-led shared decision making on patients’ satisfaction and appropriateness of their anticoagulation therapy in newly diagnosed atrial fibrillation patients.

Methods

A prospective 2-phase before and after single-centre study was conducted in an Australian hospital. Phase 1 provided usual care, and patients’ satisfaction and appropriateness of their anticoagulation therapy were evaluated. Phase-2 assessed the impact on satisfaction and appropriateness of anticoagulant therapy following pharmacist-led interventions of shared decision making to promote patients’ involvement.

Results

Patients with pharmacist-led shared decision making reported higher degree of appropriateness of anticoagulation therapy and satisfaction (36% vs 92%, P < 0.001; 25% vs 68, P < 0.001), respectively. Additionally, patients who had a pharmacist input during their hospital stay received guideline-recommended anticoagulant therapy and reported satisfaction with their management was also higher in stage 2 (21% vs 65%, p < 0.001).

Conclusion

The study highlights pharmacist-led shared decision making in atrial fibrillation that contributes to patient satisfaction and appropriateness of therapy.

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Data availability

Data presented in this manuscript is available upon reasonable request.

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Acknowledgments

The authors would like to thank Stefanie Stattmann and Katharina Heitzeneder for assistance with some of the data collection.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Peninsula Health, Frankston, Victoria, 3199, Australia

    Viviane Khalil, Samantha Blackley & Ashwin Subramaniam

  2. Monash University, Clayton , Vic 3800, Australia

    Viviane Khalil & Ashwin Subramaniam

  3. The Bays Hospital, Vale St, Mornington, 3931, Australia

    Ashwin Subramaniam

Authors
  1. Viviane Khalil
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  2. Samantha Blackley
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  3. Ashwin Subramaniam
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Contributions

VK & AS contributed to the study conception and design. Material preparation and data analysis were performed by VK. Part of the data collection was completed by SB. The draft of the manuscript was written by VK. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Viviane Khalil.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The project was approved by the hospital research and ethics committee. Ethics application number QA/16/PH29. Informed consent was obtained for all patients.

Informed consent

All subjects enrolled into the study voluntarily agreed to participate in the study and signed an informed consent form before any study procedure in compliance with the Declaration of Helsinki.

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Khalil, V., Blackley, S. & Subramaniam, A. Evaluation of a pharmacist-led shared decision-making in atrial fibrillation and patients’ satisfaction—a before and after pilot study. Ir J Med Sci 190, 819–824 (2021). https://doi.org/10.1007/s11845-020-02343-y

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  • DOI: https://doi.org/10.1007/s11845-020-02343-y

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