Key result
Newly prescribed cardiovascular medications face ~43% discontinuation, driven by side effects and knowledge gaps.
Why the study?
Readmission to primary care is challenging for patients due to multiple healthcare providers and difficulties implementing new cardiovascular medicines into their daily routine, necessitating understanding of patient needs to tailor counseling support.
Patients face significant barriers, such as lack of basic knowledge, when implementing new cardiovascular medications, highlighting the need for tailored counseling and organizing tools by pharmacists.
Barriers to new CV medicines may affect adherence; hypothesis-generating for pharmacist counseling trials.
BACKGROUND: Readmission to primary care is challenging for patients due to involvement of multiple healthcare providers across different settings and implementing new medicines into their daily routine. Elucidating patients' needs is crucial to tailor counseling support. OBJECTIVE: To explore the patient perspectives on implementing a newly prescribed cardiovascular medicine into their daily routine at readmission to primary care. METHODS: A qualitative study was performed within the outpatient pharmacy. Adult patients who were prescribed a new cardiovascular medicine by their treating hospital physician at hospital discharge or during an outpatient clinic visit were eligible to participate. Purposive sampling was applied to equally distribute adherence-influencing factors. Patients were interviewed by telephone and inclusion continued until theoretical data saturation. An adapted Greenhalgh framework for implementation research was used for a thematic content analysis by conceptualizing the new medicine as an innovation that requires implementation by a patient (adopter). RESULTS: Data saturation was reached at 44 patients of which 19 discontinued their new medicine at the time of the interview. Reasons for discontinuing included: side-effects, insufficient efficacy or negligence. Patients considered a lack of basic knowledge on their newly prescribed cardiovascular medicine as a major barrier for adopting it into their daily routine. They were in need of information on risks and benefits of their new medicine. A noticeable effect and tailored counseling facilitated patients in taking their medicine as prescribed. Patients mentioned personalized organizing tools and routinization of medication intake as important success factors for addressing their practical challenges with their new medicine. CONCLUSIONS: By applying the adapted Greenhalgh framework, this study provided a unique and structured insight in patients' barriers and facilitators that could influence their ability to implement a new cardiovascular medicine at readmission to primary care. This knowledge enables pharmacists to tailor their patient support and provide individualized patient counseling.
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Ensing et al. (2022) studied Prescribed a new cardiovascular medicine (n=44). Newly prescribed cardiovascular medicine was evaluated on Patient perspectives on implementing a newly prescribed cardiovascular medicine into their daily routine. Among 44 patients prescribed a new cardiovascular medicine, 19 discontinued it, citing side-effects, insufficient efficacy, negligence, and lack of basic knowledge as major barriers.
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