Patient experiences of pharmacist independent prescriber-led post-myocardial infarction left ventricular systolic dysfunction clinics

Int J Pharm Pract. 2021 Feb 10;29(1):55-60. doi: 10.1111/ijpp.12662.

Abstract

Objectives: Left ventricular systolic dysfunction (LVSD) is common following myocardial infarction (MI). Pharmacological management of secondary prevention is known to be sub-optimal. Integration of pharmacists into clinical teams improves prescribing and quantitative outcomes. Few data have been published on patient views of pharmacist input. We aimed to explore patient experiences of attending a dedicated pharmacist independent prescriber (PIP)-led clinic.

Methods: Semi-structured face-to-face interviews. Participants were aged ≥18 years with new incident MI and echocardiographically confirmed LVSD. Patients were recruited from three pharmacist-led clinics at point of clinic discharge. Interviews were transcribed verbatim. Thematic analysis was undertaken.

Key findings: Twelve patients were recruited, median age 67.5 years and ten male. Six core themes were identified: multidisciplinary working; satisfaction; confidence in the pharmacist; comparative care; prescribing behaviours; and monitoring. Pharmacist clinics complemented other established post-MI services, and participants perceived benefits obtained through effective inter-professional working. Participants welcomed dedicated appointment time, the opportunity to ask questions and address problems. Pharmacist explanations of condition and medicines, prescribing at the point of care and monitoring were beneficial and reduced patient stress.

Conclusions: This study demonstrates that a PIP-led post-MI LVSD clinic delivers a positive initial patient experience. More research is needed to understand the longer-term patient experiences, the impact of such models on medication taking behaviours and the experiences of carers and other members of the multidisciplinary team.

Keywords: cardiac rehabilitation; coronary heart disease; medicines optimisation; patient experiences; pharmacist.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Drug Prescriptions
  • Humans
  • Male
  • Myocardial Infarction* / drug therapy
  • Patient Outcome Assessment
  • Pharmacists*
  • Professional Role