Abstract 113: Pharmacists' Perspectives of an Intervention to Improve Medication Adherence after ACS Hospitalization A Qualitative Analysis
Background: Despite the success of pharmacist-led interventions to improve medication adherence, pharmacists’ perspectives of these interventions are unknown. Our objective was to understand the pharmacists’ perspectives of a successful multifaceted intervention to improve medication adherence after acute coronary syndrome (ACS) hospitalization.
Methods: We ascertained pharmacist perspectives’ through qualitative inquiry that included an open-ended survey, semi-structured interviews, and a focus group with the four pharmacists who participated in the intervention. Transcripts of surveys and interviews were analyzed using a content analysis approach. The intervention components included: 1) patient education; 2) assessment tools for potential medication adherence barriers; 3) collaborative care; and 4) automated medication refill reminders and educational messages. Pharmacists’ perspectives on each of these components were evaluated.
Results: The pharmacists felt the intervention could be sustained in routine clinical care and identified key themes that facilitated intervention success. Pharmacists believed educating patients about their cardiovascular medications filled a gap in usual care. In addition, assessment tools that identified medication discrepancies and gaps in knowledge were helpful in tailoring patient education, while face-to-face conversations were more helpful in identifying mental and cognitive deficits that were barriers to adherence. Pharmacists also noted that the intervention led to the development of bi-directional relationships with patients through increased in-person and tele-health communication. As a result, poor adherence related to medication side effects was more readily addressed. Potential areas for improvement identified by the pharmacists included 1) emphasizing in-person visits to build relationships (begin the educational process while the patient is hospitalized and schedule both the follow-up clinic appointment and pharmacy visit at the same time); 2) utilizing the patient centered medical home concept to improve access to providers; 3) allowing sites to determine provider type to support the personal contact (i.e. pharmacist, nurse practitioner, registered nurse); and 4) employing interactive voice response (IVR) technology to facilitate communication.
Conclusions: Pharmacists’ perspectives of a medication adherence intervention gave insights into reasons for the intervention success and suggestions for improvements and dissemination. We found that in-person meetings between pharmacists and patients led to bi-directional conversations and relationships with providers, which positively influenced patient adherence behavior. Future interventions designed to improve medication adherence should incorporate these pharmacist-identified factors.
Author Disclosures: K.B. Fehling: None. A. Lambert-Kerzner: None. R. Davis: None. J. Weaver: None. C. Barnett: None. H. Mun: None. P. Khanal: None. S.M. Bradley: None. P. Ho: None.
- © 2014 by American Heart Association, Inc.