Pharmacist-led cardiovascular risk prevention in Western Canada: a qualitative study

Abstract

Objectives Preventing cardiovascular diseases (CVD) is a public health and policy priority, including for employers. A novel CVD risk management programme that included medication management was delivered by pharmacists to employees of a Canadian university. This qualitative study describes the experiences and perceptions of participants who received individual health consultations in this programme. Methods A qualitative study design using free-text responses was adopted. Data (5658 words) came from evaluation surveys completed by 119 programme participants were iteratively coded and thematically analysed. Key findings We identified four themes characterising participant experiences of pharmacist-led CVD prevention. Theme one was labelled self-efficacy because personalised health information and advice on CVD risk factor management empowered participants to make improvements for their health. Participants expressed a range of positive responses about the longer consultations, supportive communication and safe setting of their pharmacist-led encounters; hence, Theme two is labelled pharmacists’ interpersonal skills. The wider context of the programme included a number of enabling factors (Theme three) that either supported or limited participant engagement in the programme. A number of changes to behaviour and health measures were identified and participant suggestions to expand and continue the programme further contributed to perceptions of positive programme impact (Theme four). Conclusions This study raises questions about how external resources and broader determinants might enable, or hinder, future programme success and sustainability. It also highlights the need for greater understanding and communication of the importance of primary prevention and the role of pharmacists in CVD risk reduction and workplace health promotion.

Setting Goals to Reduce Cardiovascular Risk: A Retrospective Chart Review of a Pharmacist-Led Initiative in the Workplace

“…This is partially due to a lack of willingness and time, as well as limited opportunity for primary care providers to have these discussions with other healthcare providers [38,39] The workplace offers a new setting where CVD primary prevention can be undertaken with other healthcare providers such as pharmacists using a holistic approach which can best support the efficacy and maintenance of health promotion and CVD risk reduction [5]. While many studies support the role of goal-setting discussions and motivational interviewing in CVD prevention, there is scant literature on the goal-setting process in shared decision-making between patients and providers [5,8,12,17,37,40].…”

“…The program was run by a university-affiliated, licensed, pharmacist-led health site with a focus on patient care, learner education, and development of pharmacist practice models in the Canadian context [7], in partnership with the university's Health, Wellbeing and Benefits team. The pharmacist-led and employersupported health and wellness program included 178 patients who completed a 12-month intervention, which resulted in significant improvements in clinical markers, risk scores, quality of life and medication adherence [8,9].…”

“…CVD risk management requires addressing many lifestyle factors, including smoking cessation, diet, physical activity, alcohol consumption and medication use. Previous studies have shown that motivational interviewing and goal-setting can improve a patient's success in making these lifestyle changes [5,[8][9][10][11][12][13][14][15][16][17]. However, patient or provider perspectives on the goal-setting process have not been well outlined in cardiovascular disease prevention.…”