Key result
Community pharmacists perceive themselves as important members of multidisciplinary heart failure teams but identify diagnostic uncertainty, lack of information sharing, and insufficient resources as major barriers to optimal care.
Why the study?
Heart failure guidelines recommend multidisciplinary management, but the perceptions of community pharmacists regarding their role in heart failure care needed exploration.
Community pharmacists are motivated to participate in multidisciplinary heart failure care but require improved medical data exchange and interprofessional relationships to overcome current barriers.
Barriers may limit pharmacists' HF role expansion; hypothesis-generating for interventions improving data exchange and GP collaboration.
BACKGROUND: Heart failure (HF) is an important health problem and guidelines recommend multidisciplinary management. The pharmacist is an important member of the multidisciplinary heart failure team, both in the hospital and community setting. This study aims to explore the perceptions of community pharmacists on their role in HF care. METHODS: We conducted a qualitative study based on face-to-face semi-structured interviews with 13 Belgian community pharmacists between September 2020 and December 2020. We used the Qualitative Analysis Guide of Leuven (QUAGOL) method as guidance for data analysis until data saturation was reached. We structured interview content into a thematic matrix. RESULTS: We identified two major themes: heart failure management and multidisciplinary management. Pharmacists feel responsible for the pharmacological and non-pharmacological management of heart failure, citing easy access and pharmacological expertise as important assets. Diagnostic uncertainty, lack of knowledge and time, disease complexity and difficulties in communication with patients and informal care providers are barriers to optimal management. General practitioners are the most important partners in multidisciplinary community heart failure management, although pharmacists perceive a lack of appreciation and cooperation and deplore communication difficulties. They feel intrinsically motivated to provide extended pharmaceutical care in HF but cite the lack of financial viability and information sharing structures as important barriers. CONCLUSION: The importance of pharmacist involvement in multidisciplinary heart failure teams is undisputed by Belgian pharmacists, who cite easy access and pharmacological expertise as important assets. They point out several barriers impeding evidence-based pharmacist care for outpatients with heart failure: diagnostic uncertainty and disease complexity, lack of multidisciplinary information technology and insufficient resources. We recommend that future policy should focus on improved medical data exchanges between primary and secondary care electronic health records as well as the reinforcement of interprofessional relationships between locally affiliated pharmacists and general practitioners.
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Raat et al. (2023) studied Heart failure (n=13). Multidisciplinary heart failure care was evaluated on Perceptions of community pharmacists on their role in heart failure care. Community pharmacists perceive themselves as important members of multidisciplinary heart failure teams but identify diagnostic uncertainty, lack of information sharing, and insufficient resources as major barriers to optimal care.
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