Experiences of a community pharmacy service to support adherence and self-management in chronic heart failure

Lowrie, Richard; Johansson, Lina; Forsyth, Paul; Bryce, Stuart Lochhead; McKellar, Susan; Fitzgerald, Niamh

doi:10.1007/s11096-013-9889-2

Cited by 34 publications

(38 citation statements)

References 41 publications

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“…28,29,36 However, those using pharmacy services are much less likely to raise concerns of privacy. 37 It seems possible that the general public who are not accessing clinical services through pharmacies may be unaware of recent contractual developments such as the requirement for pharmacies to have consultation rooms.…”

Section: Discussionmentioning

confidence: 99%

Support for community pharmacy-based alcohol interventions: a Scottish general public survey

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Support for community pharmacy-based alcohol interventions: a Scottish general public survey

et al. 2015

Self Cite

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“…5,6 Patient disability, disease burden and decompensation undermine adherence to recommended self-management behaviours. 7,8 Non-adherence to recommended treatment plans is common in CHF, 6,9 with reports that up to 60 % of patients do not adhere to their medication regimens as prescribed and up to 80 % do not adhere to lifestyle recommendations. 5,10 Van der Waal et al 6 also found that patients tend to tolerate exacerbations in their CHF symptoms and delay seeking assistance.…”

Section: Self-management Interventions In Chf: Do They Work?mentioning

confidence: 99%

Patient Self-Management In Chronic Heart Failure — Establishing Concordance Between Guidelines And Practice

Toukhsati¹,

Driscoll²,

Hare³

2015

Cardiac Failure Review

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The gold-standard of patient self-management in chronic heart failure (CHF) can be defined as "daily activities that maintain clinical stability". 1 This requires that patients monitor their symptoms, adhere to their medication, diet and exercise regimens and manage symptoms by recognising changes and responding by either adapting behaviours or by seeking appropriate assistance.2 Patient self-management is linked to reduced mortality risk and fewer hospital admissions; however, there is less certainty with regard to the benefits of some aspects of self-care, such as lifestyle choices and fluid restriction.2 According to the European Society of Cardiology Guidelines for the diagnosis and treatment of acute and chronic heart failure, 3 self-management is integral to achieving best patient outcomes: to reduce mortality and improve quality of life.Self-management in CHF usually involves behavioural adaptation.Patients may need to learn new behaviours, such as learning how to monitor and manage symptoms and complex medical regimens.Patients may also need to abstain (e.g. cease smoking), adapt (e.g. AbstractChronic heart failure (CHF) is a progressive and debilitating disease with a broad symptom profile, intermittently marked by periods of acute decompensation. CHF patients are encouraged to self-manage their illness, such as adhering to medical regimens and monitoring symptoms, to optimise health outcomes and quality of life. In so doing, patients are asked to collaborate with their health service providers with regard to their care. However, patients generally do not self-manage well, even with specialist support. Moreover, selfmanagement interventions are yet to demonstrate morbidity or mortality benefits. Social network approaches to self-management consider the availability and mobilisation of all resources, beyond those of only the patient and healthcare providers. Used in conjunction with e-health platforms, social network approaches may offer a means by which to optimise self-management programmes of the future.

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“…The views and perspectives of patients with LTCs are usually incorporated in research that focus on interventions such as specific services [30, 38], LTCs-specific intervention [39, 40], medicines management services [41, 42] adherence-improving interventions [43], and lifestyle and public health interventions [44, 45]. However, these focus on patients’ preferences, experiences and satisfaction with these services and interventions.…”

Section: Introductionmentioning

confidence: 99%

Self-care of long-term conditions: patients’ perspectives and their (limited) use of community pharmacies

et al. 2017

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Background Self-care support is an ‘inseparable’ component of quality healthcare for long-term conditions (LTCs). Evidence of how patients view and use community pharmacy (CP) to engage in self-care of LTCs is limited. Objective To explore patients’ perspectives of engaging in self-care and use of CP for self-care support. Setting England and Scotland. Method Qualitative design employing semi-structured interviews. LTCs patients were recruited via general practitioners (GPs) and CPs. Interviews were conducted between May 2013 and June 2014; they were audio-recorded, transcribed verbatim and analysed thematically. Results Twenty-four participants were interviewed. Three main themes emerged: engaging in self-care, resources for self-care support and (limited) use of community pharmacy. Participants’ LTC ‘lived experience’ showed that self-care was integral to daily living from being diagnosed to long-term maintenance of health/wellbeing; self-care engagement was very personal and diverse and was based on beliefs and experiences. Healthcare professionals were viewed as providing information which was considered passive and insufficient in helping behavioural change. Non-healthcare sources (family, carers, friends, internet) were important in filling active support gaps, particularly lifestyle management. Participants’ use of, and identified need for, community pharmacy as a resource for self-care support of LTCs was limited and primarily focussed on medicines supply. There was low awareness and visibility of CPs’ potential roles and capability. Conclusion CP needs to reflect on patients’ low awareness of its expertise and services to contribute to self-care support of LTCs. Rethinking how interventions are designed and ‘marketed’; incorporation of patients’ perspectives and collaboration with others, particularly GPs, could prove beneficial.

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Experiences of a community pharmacy service to support adherence and self-management in chronic heart failure

Cited by 34 publications

References 41 publications

Support for community pharmacy-based alcohol interventions: a Scottish general public survey

Support for community pharmacy-based alcohol interventions: a Scottish general public survey

Patient Self-Management In Chronic Heart Failure — Establishing Concordance Between Guidelines And Practice

Self-care of long-term conditions: patients’ perspectives and their (limited) use of community pharmacies

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