How the community pharmacist contributes to the multidisciplinary management of heart failure
E. Chauvelot, V. Nerich, S. Limat, M. F. Seronde, M. C. Woronoff-Lemsi
.
DOI: 10.4236/health.2010.29160   PDF    HTML     4,156 Downloads   8,246 Views   Citations

Abstract

Objective: To define how the community pharmacist contributes to the management of heart failure by exploring the type of service he provides to patients and by assessing what patients expect from him. Setting: Pharmacists of the Franche-Comte region (France) and patients of the Franche-Comté Heart Association. Method: Two questionnaires were drawn up and sent to pharmacists and patients. Results: The 118 pharmacists participating in this survey (36.9%) felt that they had a role to play in dispensing drugs (100.0%), educating patients about their treatment (83.1%), informing patients about the importance of observance (81.4%) and over- the-counter drugs (58.5%), distributing heart failure brochures (51.7%) and providing medical equipment (44.9%). On the other hand, only a third of them thought that they should inform patients about their illness and give advice by phone. On the whole, knowledge level is good for disease, drug therapy, contraindicated drugs, medical supervision and hygieno-dietetic management, but intermediate or poor for alert signs of decompensation, essential vaccinations and patient associations. University training in this area during formal pharmacy studies is considered either “insufficient” or “very insufficient” in 56.9% of cases. Although more than 99% of the pharmacists think that additional training is needed, only 33.1% had actually benefited from such training. Of the 96 patients (48.0%) who completed the questionnaire, 92.6% are faithful to their pharmacist. They contact him more about drug therapy than about their disease, or information related to treatments. Roles attributed to their pharmacist are mainly related to drug therapy explanation and information concerning over-the-counter drugs. Therapeutic education is known to 40.6% of interrogated patients. Among these patients, two-thirds depend on their pharmacist and feel that he is capable of providing the necessary education. Moreover, 46.2% of patients had received some form of therapeutic education from their pharmacist. Pharmacists believe that they are able to assume this role in 67.8% of cases. Conclusion: In spite of biases, this study allowed us to assess the expectations of heart failure patients with regard to the pharmaceutical management of their disease, thus clarifying the indispensable contribution that pharmacists make in the management of this disease.

Share and Cite:

Chauvelot, E. , Nerich, V. , Limat, S. , Seronde, M. and Woronoff-Lemsi, M. (2010) How the community pharmacist contributes to the multidisciplinary management of heart failure. Health, 2, 1087-1092. doi: 10.4236/health.2010.29160.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Arnold, J.M., Liu, P., Demers, C., Dorian, P., Giannetti, N., Haddad, H., Heckman, G.A., Howlett, J.G., Igaszewski, A., Johnstone, D.E., Jong, P., McKelvie, R.S., Moe, G.W., Parker, J.D., Rao, V., Ross, H.J., Sequeira, E.J., Svendsen, A.M., Teo, K., Tsuyuki, R.T. and White, M. (2006) Canadian cardiovascular society consensus conference recommendations on heart failure 2006: Diagnosis and management. The Canadian Journal of Cardiology, 22(1), 23-45.
[2] Delahayeand F. and de Gevigney, G. (2001) Epidémiologie de l'insuffisance cardiaque. Annales de Cardiologie et d’Angéiologie, 50(1), 6-11.
[3] Vinson, J.M., Rich, M.W., Sperry, J.C., Shah A.S. and McNamara, T. (1990) Early readmission of elderly patients with congestive heart failure. Journal of the American Geriatrics Society, 38(12), 1290-1295.
[4] Racine-Morel, A., Deroche, S., Bonnin, C., Gérard C. and Matagrin, C. (2006) Prise encharge dupatient insuffisant cardiaque: évolution, organisation, application àl'échelle locale. Annales de Cardiologie et d'Angéiologie, 55(6), 352-357.
[5] Rich, M.W., Beckham, V., Wittenberg, C., Leven, C.L., Freedland K.E. and Carney, R.M. (1995) A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. The New England journal of Medicine, 233(18), 1190-1195.
[6] Koelling, T.M., Johnson, M.L., Cody R.J. and Aaronson K.D. (2005) Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation, 111(2), 179-185.
[7] Gwadry-Sridhar, F., Guyatt, G., O'Brien, B., Arnold, J.M., Walter, S., Vingilis, E. and MacKeigan, L. (2008) TEACH: Trial of education and compliance in heart dysfunction chronic disease and heart failure (HF) as an increasing problem. Contemporary Clinical Trials, 29(6), 905-918.
[8] Omar, A.R., Suppiah, N., Chai, P., Chan, Y.H., Seow, Y. H., Quek, L.L., Poh, K.K. and Tan, H.C. (2007) Efficacy of community-based multidisciplinary disease management of chronic heart failure. Singapore Medical Journal, 48(6), 528-531.
[9] Bouvy, M.L., Heerdink, E.R., Urquhart, J., Grobbee, D.E., Hoes A.W. and Leufkens, H.G. (2003) Effect of a pharmacist-led intervention on diuretic compliance in heart failure patients: A randomized controlled study. Journal of Cardiac Failure, 9(5), 404-411.
[10] Holland, R., Brooksby, I., Lenaghan, E., Ashton, K., Hay, L., Smith, R., Shepstone, L., Lipp, A., Daly, C., Howe, A., Halland R. and Harvey, I. (2007) Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial. British Medical Journal, 334(7603), 1098-1101.
[11] Sadik, A., Yousifand, M. and McElnay, J.C. (2005) Pharmaceutical care of patients with heart failure. British Journal of Clinical Pharmacology, 60(2), 183-193.
[12] Murray, M.D., Young, J.M., Morrow, D.G., Weiner, M., Tu, W., Hoke, S.C., Clark, D.O., Stroupe, K.T., Wu, J., Deer, M.M., Bruner-England, T.E., Sowinski, K.M., Smith, F.E., Oldridge, N.B., Gradus-Pizlo, I., Murray, L.L., Brater D.C. and Weinberger, M. (2004) Methodology of an ongoing, randomized, controlled trial to improve drug use for elderly patients with chronic heart failure. The American Journal of Geriatric Pharmacotherapy, 1(1), 53-65.
[13] Murray, M.D. Young, J., Hoke, S., Tu, W., Weiner, M., Morrow, D.D., Stroupe, K.T., Wu, J., Clarke, D., Smith, F., Gradus-Pizlo, I., Weinberger, M. and Brater, D.C. (2007) Pharmacist intervention to improve medication adherence in heart failure: A randomized trial. Annals of Internal Medicine, 146(10), 714-725.
[14] Gattis, W.A., Hasselblad, V., Whellanand, D.J. and O' Connor, C.M. (1999) Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: Results of the pharmacist in heart failure assessment recommendation and monitoring (PHARM) study. Archives of Internal Medicine, 159(16), 1939-1945.
[15] Department of Health (2005) Choosing health through pharmacy—A programme for pharmaceutical public health 2005-2015. Department of Health, London.
[16] Bucci, C. Jackevicius, C., McFarlane K. and Liu, P. (2003) Pharmacist’s contribution in a heart function clinic: Patient perception and medication appropriateness. The Canadian Journal of Cardiology, 19(4), 391-396.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.