Purpose

To explore patient's understanding of their cardiovascular therapy, investigate factors leading to non-compliance, and to assess the contribution of pharmacist medication review to patient education.

Method

Patient medication records were used to identify patients taking two or more cardiovascular drugs. Community Pharmacists conducted a structured questionnaire interview with consenting ambulatory patients from October 2000 - December 2001. Pharmacists carried out follow-ups on an average of 8-months after the initial survey. Overall cardiovascular medication knowledge scores were calculated at initial and follow-up surveys.

Results

Thirteen community pharmacists collected data from 143 patients (mean age 65.5 years ± SD10.7) who were prescribed 498 cardiovascular drugs (mean no./ patient 3.5 ± SD 1.5), 336 of the medications had been prescribed over a year prior to the study. Thirty-four percent (48/143) of patients replied that they did not always take their medicines as prescribed, most of these patients took less than was prescribed. The reasons given for taking less of their medicines were forgetfulness, adverse effects, and feeling that the dose prescribed was not necessary. Queries about patients' cardiovascular drug knowledge revealed that 57% (82/143) of the patients knew the names of all of their cardiovascular drugs. Thirty-two percent (46/143) could name some of their drugs, and 10% (15/143) did not know any of their cardiovascular drug names. Similarly, 49% of the patients (70/143) provided plausible indications for all of their drugs, 43% (61/143) knew some, and 8% (12/143) did not know the indication for any. Knowledge of medication regimen was incorrect for 5% of the drugs. Patients' overall median drug knowledge scores improved from an initial score of 83%, to 100% at follow-up for 44% (36/82) of the patients.

Limitations

Once identified, cardiovascular patients volunteered to participate, which may have introduced selection bias. Patients surveyed were from a small number of pharmacies. Questions were aimed at determining knowledge of cardiovascular drugs; other concurrent medications were not evaluated.

Conclusion

Community Pharmacists were able to identify a number of drug-related problems in a sample of ambulatory cardiovascular patients. Through medication review, the pharmacists were able to improve patients' knowledge of their cardiovascular drugs.