Pharmacist-led medication management services: a qualitative exploration of transition-of-care cardiovascular disease patient experiences

Author:

Bennetts JoshuaORCID,White Jennifer,Croft Hayley,Cooper JoyceORCID,McIvor Dawn,Eadie Nicholas,Appay Marcelle,Sverdlov Aaron L,Ngo Doan

Abstract

ObjectiveHospitalisation due to medication-related problems is a major health concern, particularly for those with pre-existing, or those at high risk of developing cardiovascular disease (CVD). Postdischarge medication reviews (PDMRs) may form a core component of reducing hospital readmissions due to medication-related problems. This study aimed to explore postdischarge CVD patients’ perspectives of, and experiences with, pharmacist-led medication management services. A secondary aim explored attitudes towards the availability of PDMRs.DesignAn interpretative qualitative study involving 16 semistructured interviews. Data were analysed using an inductive thematic approach.SettingPatients with CVD discharged to a community setting from the John Hunter Hospital, an 820-bed tertiary referral hospital based in New South Wales, Australia.ParticipantsPatients with pre-existing or newly diagnosed CVD who were recently discharged from the hospital.ResultsA total of 16 interviews were conducted to reach thematic saturation. Nine participants (56%) were male. The mean age of participants was 57.5 (±13.2) years. Three emergent themes were identified: (1) poor medication understanding impacts transition from the hospital to home; (2) factors influencing medication concordance following discharge and (3) perceived benefits of routine PDMRs.ConclusionsThere is a clear need to further improve the quality use of medicines and health literacy of transition-of-care patients with CVD. Our findings indicate that the engagement of transition-of-care patients with CVD with pharmacist-led medication management services is minimal. Pharmacists are suitable to provide essential and tailored medication review services to patients with CVD as part of a multidisciplinary healthcare team. The implementation of routine, pharmacist-led PDMRs may be a feasible means of providing patients with access to health education following their transition from hospital back to community, improving their health literacy and reducing rehospitalisations due to medication-related issues.

Funder

Heart Foundation Australia

New South Wales Ministry of Health EMC Fellowship

Piggotts Family Trust - Hunter Medical Research Institute

John Hunter Hospital Charitable Trust Grant

Royal Australasian College of Physicians Foundation Research Establishment Award

Australian Government Research Training Program Scholarship - Commonwealth of Australia

New South Wales Ministry of Health Translational Research Grant

Publisher

BMJ

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