Intervention of the pharmacist with patients on cardiovascular drugs
Pharmacist interventions can provide patient-specific guidance to identify and resolve medication regimen issues to ensure optimal outcomes.
As drug experts, the pharmacist informs the patient about his prescriptions. Because pharmacists are easily accessible, patients frequently call and visit community pharmacies for advice.
Without drug information, patients may experience drug-related problems, leading to high costs and even morbidity or mortality. A UK study reported that 66% of patients who started new medications experienced medication-related problems within 10 days of initiation.
The National Center for the Development of Pharmacy Practice in Norway studied the effects of pharmacist intervention on drug-related problems. Patients who initiated new cardiovascular drugs received advice from pharmacists 1-2 and 3-5 weeks after filling the prescription.
Then, the patients completed a questionnaire on the satisfaction of the council. Medisinstart, a standard pharmaceutical healthcare service in Norway, then tracked pharmacist advice and patient medication issues to identify trends.
Pharmacist interventions provided patient-specific advice to identify and resolve problems. Some patients experienced adverse effects (AEs), but not all received advice on management.
Compared to patients who did not receive counselling, those who received counseling at the first visit were more likely to have their issues resolved at visit 2 (61.2% vs 42.6%). Researchers were interested in examining problems that persisted or developed after visit 1 because they demonstrate that repeat visit is necessary for optimal intervention.
Repeat visits are also important for medications such as statins, the symptoms of which can develop months after the visit.
The study used 2 questionnaires: a medical beliefs questionnaire (BMQ) and a satisfaction survey. The BMQ was noted for patients’ belief in the need for the drug and their concerns about the drug.
Higher scores indicated a strong need or concern for a new drug. Patients with higher BMQ concern scores were associated with more medication-related problems and AEs.
The investigators believe that these adverse effects were due to the nocebo effect (adverse effects due to belief). These patients were more worried at baseline and reported more AEs during consultations.
The satisfaction survey showed that female patients, older patients, those with longer first consultations, and those receiving their first consultation in person were more likely to report higher satisfaction. Improved communication (longer consultation, face-to-face interaction) corresponded directly to improved satisfaction scores. Patient satisfaction is a way to measure the quality of health care services.
The study recruited 629 patients with 566-570 of the patients responding to the questionnaire. The limitations of the study were the absence of a control group and the non-validated questionnaire.
These limitations prevented the researchers from concluding that a reduction in the need for information and a decrease in drug-related problems were directly related to the intervention. Researchers have demonstrated that there may be a relationship between the intervention and a decrease in drug-related problems, however, further randomized controlled trials are needed.
About the Author
DylanDeCandia is a 2023 PharmD candidate at the University of Connecticut.
- Bremer S, Henjum S, Sæther EM, Hovland R. Medication issues and satisfaction in patients receiving pharmacist-led consultations at the start of cardiovascular medications. Res Social Admin Pharm. June 16, 2022: S1551-7411(22)00183-8. doi: 10.1016/j.sapharm.2022.06.005. Epub ahead of print. PMID: 35750567.
- Barber N, Parsons J, Clifford S, Darracott R, Horne R. Patient issues with new drugs for chronic disease. Qual Saf Health Care. 2004;13:172–175.