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Barriers to Medication Adherence in Chronic Heart Failure Patients during Home Visits
Author(s) -
Toh Cjeng T,
Jackson Bruce,
Gascard Debra J,
Manning Alison R,
Tuck Emily J
Publication year - 2010
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2010.tb00721.x
Subject(s) - medicine , heart failure , pharmacist , psychological intervention , referral , medication adherence , observational study , dosing , emergency medicine , adverse effect , intensive care medicine , physical therapy , medical emergency , pharmacy , family medicine , nursing
Aim To identify barriers to medication adherence in chronic heart failure patients during home visits; and to find solutions to address medication non‐adherence. Method This was an observational study of home visits by the chronic heart failure pharmacist that was made after referral from a multidisciplinary chronic heart failure service. The reasons for medication non‐adherence and solutions to overcome them were recorded in 66 consecutive chronic heart failure patients. Barriers to medication adherence and subsequent interventions (education, counselling, motivational interviews), hospital readmissions, length of stay, mortality and cause of death were analysed 3 months after the first home visit. Results Main reasons for medication non‐adherence were poor and/or complex medication instructions (71%), running out of medications (33%) and adverse drug reactions (20%). Interventions included education and counselling (100%), reducing dosing frequency (64%) and introducing dose administration aids (32%). 10 complex chronic heart failure patients (15%) required multiple home visits, motivational interviews and telephone coaching. Hospital readmissions, average length of stay for readmissions and deaths due to chronic heart failure 3 months after the first home visit were 4.5%, 6.3 days and 3%, respectively. Conclusion Multiple strategies were necessary to overcome barriers to medication adherence in chronic heart failure patients. Home visits by the pharmacist optimised medication adherence, thus potentially minimising unplanned hospital admissions.