Forsyth, P., Richardson, J. and Lowrie, R. (2019) Patient-reported barriers to medication adherence in heart failure in Scotland. International Journal of Pharmacy Practice, 27(5), pp. 443-450. (doi: 10.1111/ijpp.12511) (PMID:30675955)
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Abstract
Medication adherence is the end result of a complex set of interwoven factors. Non-adherence with medication in heart failure patients is associated with excess mortality and morbidity. Studies describing interventions to improve adherence in heart failure are limited by a lack of robust methods and inconsistent outcomes. The aim of this evaluation was to explore the barriers to medication adherence in Scottish heart failure patients in order to inform the development of complex interventions. Qualitative patient interviews. Participants were aged ≥18 years with current or previous signs or symptoms of clinical heart failure, reduced left ventricular ejection fraction ≤45% and confirmed adherence of <80% in tablet counts of heart failure therapy. Thematic analysis was employed. Eleven patients were recruited. The median age was 79 years old, and participants were typically from socially deprived communities. Participants were prescribed a mean 9.9 different medications per day. Seven distinct themes emerged around barriers to medication adherence: co-morbidity; treatment burden; health literacy; trust in NHS; socioeconomic factors; autonomy and health expectations. The factors affecting medication adherence in heart failure are multi-factorial and are unlikely to be improved by one single-faceted intervention. Future interventions need to treat patients holistically, build their trust as partners, simplify complex treatment regimens where possible and involve educational and social elements. The skill set and opportunities afforded to pharmacists may be well placed to deliver many of these aspects but this would need tested in the context of the development of complex interventions.
| Item Type: | Articles |
|---|---|
| Additional Information: | Supported by a grant from Chest, Heart and Stroke Scotland (Charity). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Richardson, Mrs Janice |
| Authors: | Forsyth, P., Richardson, J., and Lowrie, R. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | International Journal of Pharmacy Practice |
| Publisher: | Wiley |
| ISSN: | 0961-7671 |
| ISSN (Online): | 2042-7174 |
| Published Online: | 24 January 2019 |
| Copyright Holders: | Copyright © 2019 2019 Royal Pharmaceutical Society |
| First Published: | First published in International Journal of Pharmacy Practice 27(5):443-450 |
| Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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