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

Joshua Bennetts; Jennifer White; Hayley Croft; Joyce Cooper; Dawn McIvor; Nicholas Eadie; Marcelle Appay; Aaron L Sverdlov; Doan Ngo

doi:10.1136/bmjopen-2023-082228

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

BMJ Open. 2024 May 22;14(5):e082228. doi: 10.1136/bmjopen-2023-082228.

Authors

Joshua Bennetts^{1

2}, Jennifer White^{2

3}, Hayley Croft¹, Joyce Cooper^{1

4}, Dawn McIvor^{5

6}, Nicholas Eadie⁷, Marcelle Appay^{1

7

8}, Aaron L Sverdlov^{2

3

6}, Doan Ngo^{9

2}

Affiliations

¹ School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia.
² Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
³ School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.
⁴ College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
⁵ College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.
⁶ Cardiovascular Department, Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia.
⁷ Department of Pharmacy, Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia.
⁸ School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.
⁹ School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia doan.ngo@newcastle.edu.au.

Abstract

Objective: Hospitalisation 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.

Design: An interpretative qualitative study involving 16 semistructured interviews. Data were analysed using an inductive thematic approach.

Setting: Patients with CVD discharged to a community setting from the John Hunter Hospital, an 820-bed tertiary referral hospital based in New South Wales, Australia.

Participants: Patients with pre-existing or newly diagnosed CVD who were recently discharged from the hospital.

Results: A 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.

Conclusions: There 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.

Keywords: CARDIOLOGY; Cardiovascular Disease; Hospital to Home Transition; Medication Reconciliation; Medication Review; Pharmacists.

MeSH terms

Adult
Aged
Cardiovascular Diseases* / drug therapy
Female
Humans
Interviews as Topic
Male
Medication Adherence
Medication Therapy Management / organization & administration
Middle Aged
New South Wales
Patient Discharge*
Pharmacists*
Professional Role
Qualitative Research*