The impact of pharmacist-led medication intervention on patient perception and satisfaction following new acute coronary syndrome diagnosis prior to hospital discharge

Cardiovascular disease is a major cause of morbidity and mortality, with acute coronary syndrome (ACS) remaining the leading cause of hospital admissions in the UK^​1,2​. Strict adherence to the national guideline directed pharmacotherapy for secondary prevention of ACS is vital to improve patient outcome and reduce mortality^​3​.

As a result, researchers carried out a research study in the admissions unit at Barking, Havering and Redbridge University Hospitals NHS Trust, aimed to gather useful insights into the patient perspective and identify any additional concerns relating to the pharmacist medication-intervention service not previously raised by patients during the hospital stay. 

Researchers utilised qualitative research methodology with eight participants, utilising semi-structured interview to collect data and thematic analysis to interpret the data. Only patients with a new diagnosis of ACS and no prior hospital admissions or significant past medical history were recruited for the study. This was to ensure authentic narratives of patients are illustrated and to mitigate the possibility of subjective bias originating from prior interactions with the healthcare system.

Results 

All the patients interviewed reflected a significant lack of awareness over the visibility and availability of clinical pharmacists in a hospital ward. This was evident from their responses when asked how they came about speaking to the pharmacist. None of the patients had proactively requested to speak to a pharmacist while in hospital. 

Patients identified the role of pharmacists within a hospital pharmacy dispensary alone and therefore described pharmacist intervention at the patient bedside in a ward as unexpected. Patients had insufficient knowledge of the pharmacy services delivered by a clinical pharmacist including medication communication in a hospital ward. Any reference to healthcare professionals by the patients interviewed were mainly limited to doctors and nurses only.

Patients felt that they received sufficient information to enable them to make informed decisions regarding their medication and manage them at home with confidence. Patients reported how vital the information conveyed was especially after diagnosis of a critical conduction such as ACS. 

Participants also highlighted the preference to receive medication information at the point of initiation while still receiving care in the hospital. Anxiety related to their new heart condition diagnosis might discourage patients from seeking this information at a later stage. Some participants reported that when new medications are started in a hospital, their expectation is that a pharmacist will talk to them without the need for the patient to actively request this.

Participants had varying expectations of the type of medicine information received. Some were content with general information while others requested for specific details relating to potential side effects. 

Conclusion

This research project provided in-depth insights into the perceptions and views of patients on pharmacist-led medication intervention while still receiving care in the hospital. The pharmacist’s input was valued by patients but there was a clear awareness gap suggesting a potential underutilisation of the pharmacist skillset during the hospital stay. Creating greater awareness among hospital admitted patients regarding clinical pharmacists on the ward can be achieved through consistent communication by healthcare professionals such as doctors or nursing teams at the point of admission. This will enhance patient understanding of the clinical pharmacist role, improve visibility and increase patient understanding of their newly prescribed medicines.

The study results highlight the positive patient experience when they receive medication communication from pharmacists owing to their knowledge and expertise in the field of medicines.

Furthermore, the study also emphasises the significance of timing of intervention and tailoring the medication intervention to individual patients’ needs rather than following a set pattern further emphasising the significance of patient-centered approach.

Reeja Pillai, acute and emergency medicine pharmacist, Barking, Havering and Redbridge University Hospitals NHS Trust