Pharmaceutical Care of Patients with Congestive Heart Failure: Interventions and Outcomes

Varma, Satish; McElnay, James; Hughes, Cian; Passmore, Anthony Peter; Varma, M. P. S.

doi:10.1592/phco.19.10.860.31565

Cited by 153 publications

(241 citation statements)

References 18 publications

(22 reference statements)

Supporting

Mentioning

235

Contrasting

Unclassified

Order By: Relevance

“…[36][37][38][39][40] Some of these studies also demonstrated improvements in patients' clinical outcomes. 36,37,[39][40][41] Studies Assessing Medication Adherence A summary of studies evaluating pharmacist interventions on medication adherence is presented in Table 3. [36][37][38][39][40][41][42][43][44] One of the earliest randomized controlled trials that assessed the effect of intensive pharmacist counseling randomized 100 elderly patients with stable HF in the United Kingdom to a 3-month pharmacist counseling intervention versus standard care.…”

Section: Pharmacist Interventions To Improve Adherencementioning

confidence: 99%

See 1 more Smart Citation

The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients

Davis

Packard²,

Jackevicius

2014

JMCP

View full text Add to dashboard Cite

Section: Pharmacist Interventions To Improve Adherencementioning

confidence: 99%

“…41 Patients were randomized to a pharmacist education intervention at baseline and every 3 months, plus daily weight recordings, versus usual care. Adherence, as measured by patient-reported data, showed no significant differences between the 2 groups.…”

Section: Pharmacist Interventions To Improve Adherencementioning

confidence: 99%

The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients

Davis

Packard²,

Jackevicius

2014

JMCP

View full text Add to dashboard Cite

“…Many of the programs which have shown improvements in patient outcomes have required substantial investments in multi-disciplinary staff time which may prove to be unsustainable and infeasible in practices withlimited resources (Naylor, Brooten, & Jones, 1994;Rich, Beckham, & Wittenberg, 1995;Foranow et al, 1997;Hunt et al, 2002). Newer, less cumbersome programs involving nurse or pharmacist management have shown decreases in hospitalizations and improved quality of life (Blue et al, 2001;Krumholz et al, 2002;Varma, McElnay, Hughes, Passmore, & Varma, 1999;West et al, 1997), but withthe exception of one study (Stewart & Horowitz, 2002), there has been no clear improvement in survival. The modest success of interventions points to the need for a fundamental reexamination of how CHF patients understand and manage their physical conditions.…”

Section: Introductionmentioning

confidence: 99%

A story of maladies, misconceptions and mishaps: effective management of heart failure

Horowitz¹,

Rein²,

Leventhal³

2004

Social Science & Medicine

240

282

View full text Add to dashboard Cite

Congestive heart failure (CHF) is a common chronic disease with effective therapy, yet interventions to improve outcomes have met with limited success. Though problems in selfmanagement are suspected causes for deterioration, few efforts have been made to understand how self-management could be improved to enhance the lives of affected patients. We conducted semistructured interviews of 19 patients with CHF treated at an urban United States hospital to elucidate their knowledge and beliefs about CHF and to understand what underlies their self-care routines. A comparison of the themes generated from these interviews with the common-sense model for self-management of illness threats, clarifies how patients' perceptions and understanding of CHF affected their behaviors. Patients had an acute model of CHF. They did not connect chronic symptoms with a chronic disease, CHF, and did not recognize that these symptoms worsened over time from their baseline of moderate, chronic distress, to a severe state that required urgent care. As a consequence, they often did not manage symptoms on a routine basis and did not, therefore, prevent or minimize exacerbations. When they worsened, many patients reported barriers to reaching their physicians and most reported seeking care primarily in an emergency room.These in depth responses elucidate how the interplay between acute and chronic models of a chronic illness effect self-management behaviors. These factors play a previously not understood role in patient's efforts to understand and manage the ever-present but symptomatically variable chronic illness that is CHF. These new concepts illustrate the tools that may be needed to effectively manage this serious and disabling illness, and suggest possible ways to enhance the self-management process and ultimately improve patients' lives.

show abstract

“…This has manifested as improved control of chronic diseases, improvements in adherence, reduced medication spend per patient, and diminished hospital costs. [42][43][44] These findings have led to renewed calls for in-person pharmacist counseling and follow-up to improve medication taking behavior. 45 Related to these study findings, the next steps may involve: 1) Pharmacist follow-up to ensure patients are contacted when they have a medication on record that they have not picked up, coupled with patient education of the importance of taking it as directed.…”

Section: Discussionmentioning

confidence: 99%

Association of increased emergency rooms costs for patients without access to necessary medications

Watanabe

Ney

2015

Research in Social and Administrative Pharmacy

View full text Add to dashboard Cite

Background: Prescription medications are an important component of chronic disease management. They are vital in preventing unnecessary ER visits. However, few studies have examined the association between patients' self-reported inability to receive necessary medications and emergency room costs. Objectives: The study objectives were to: 1) determine differences in ER costs based on self-reported ability to obtain necessary medications. 2) identify differences in ER costs based on self-reported ability to obtain necessary medications among medication users. The association was also examined by insurance category. Methods: Respondent data from 10 years (2002-2011) of the U.S. Medical Expenditure Panel Survey was analyzed. The models employed estimated the association of respondents reporting being 'unable to receive necessary medications' on ER expenditures. Secondarily, the relationship was assessed by insurance category: private, public, and uninsured. Two-part cost regression models with bootstrapped estimates to produce 95% confidence intervals of cost differences were applied for these analyses. Significance was set at a ¼ 0.05. Analyses were completed using SAS 9.4 (Cary, NC) and Stata 13 (College Station, TX). Estimates were in 2011 US dollars. Results: People unable to receive necessary medications experienced increased average annual ER costs of $46.62 with 95% a confidence interval [CI] of 34.76-58.49) compared to patients able to receive necessary medications. By insurance category, respondents unable to receive necessary medications experienced increased ER costs ), for Publically Insured, Privately Insured, and Uninsured, respectively. Findings were similar for those already using medications. Conclusions: Inability to obtain necessary medications is associated with increased emergency room costs. Those with public insurance have a larger increase in ER costs if they are without necessary medications compared to those insured privately or without insurance.

show abstract

Pharmaceutical Care of Patients with Congestive Heart Failure: Interventions and Outcomes

Cited by 153 publications

References 18 publications

The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients

The Pharmacist Role in Predicting and Improving Medication Adherence in Heart Failure Patients

A story of maladies, misconceptions and mishaps: effective management of heart failure

Association of increased emergency rooms costs for patients without access to necessary medications

Contact Info

Product

Resources

About