A pharmacist-led follow-up program for patients with coronary heart disease in North Norway–a qualitative study exploring patient experiences

Abstract

BackgroundCoronary heart disease (CHD) is one of the leading causes of death worldwide. Scientific literature shows that prevention of CHD is inadequate. The clinical pharmacist’s role in patient-centred care has been shown favourable in a large amount of studies, also in relation to reduction of risk factors related to CHD. We developed and piloted a pharmacist-led follow-up program for patients with established CHD after hospital discharge from a hospital in North Norway. The aim of the present study was to explore how participants in the follow-up program experienced the program with regard to four main topics; medication knowledge, feeling of safety and comfort with medications, the functionality of the program and the clinical pharmacist’s role in the interdisciplinary team.MethodsWe performed semi-structured thematic interviews with four patients included in the program. After verbatim transcribing, we analysed the interviews using “qualitative content analyses” by Graneheim and Lundman. Trial registration http://www.clinicaltrials.gov: NCT01131715.ResultsAll participants appreciated the follow-up program because their medication knowledge had increased, participation had made them feel safe, they were reassured about the appropriateness of their medications, and they had become more involved in their own medication. The participants reported that the program was well structured and the clinical pharmacist was said to be an important caretaker in the health-care system. The importance of collaboration between pharmacists and physicians, both in hospital and primary care, was emphasized.ConclusionOur results indicate that the follow-up program was highly appreciated among the four participants included in this study. The results must be interpreted in the context of the health care system in Norway today. Here, few pharmacists are working in hospitals or in close relation to the general practitioners. In addition, physicians are short of time in order to supply appropriate medication information, both in hospital and primary care. Involving pharmacists in follow-up of patients with CHD seems to be highly appreciated among patients and may be a step towards improving patient care. The study is limited by the low number of participants.

Comprehensive medication reviews by ward‐based pharmacists in Swedish hospitals: What does the patient have to say?

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Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis

“…Heart failure (HF) and acute coronary syndrome (ACS), including ischaemic heart diseases such as myocardial infarction (MI), are associated with significant morbidity and mortality. 1,2 Although current pharmacotherapy has improved survival in patients with HF, morbidity and mortality remain high; at present, approximately 26 million people worldwide are living with HF. [3][4][5] The occurrence of acute MI confers an eightfold to 10-fold increased risk of the development of HF.…”

Patient experiences of perioperative nutrition within an Enhanced Recovery After Surgery programme for colorectal surgery: a qualitative study

“…Qualitative methods can help evaluate patients’ experiences by identifying issues that would not arise within the prespecified boundaries of quantitative research . It has been recommended that complex interventions such as ERAS programmes should be assessed using both qualitative and quantitative methods , and this approach has previously been used successfully to explore patients’ experiences of various clinical programmes .…”