Pharmacist intervention in adherence to diuretics in congestive heart failure

Abstract

Background and objective: Diuretic therapy is routinely used in the management of congestive heart failure (CHF).,Compliance with clinical practice guidelines is reported to result in improved outcomes for patients with CHF such as reduced exacerbations. The aim was to assess the effect of pharmacist intervention on adherence to diuretic treatment in a hospital and community pharmacy scenario. Setting and method: The study was undertaken at Karin Grech Hospital (KGH), a geriatric and rehabilitation hospital, and in one community pharmacy. Inclusion criteria for patients recruited from KGH were age over 60 years, suffering from CHF and on bumetanide therapy. The validated 8-item Morisky Medication Adherence Scale (MMAS-8)1 was administered to patients on admission (t = 0), repeated after two weeks hospital stay (t = 1) and again one-month post-discharge (t = 2). A total MMAS-8 score of zero indicates high adherence, a score between 1 and 2 indicates medium adherence and a score between 3 and 8 indicates low adherence. In the community setting patients on diuretic therapy were chosen by convenience sampling. The same adherence scale was administered prior to pharmacist intervention (t = 0) and one-month after pharmacist intervention (t = 1). Pharmacist intervention in the community setting involved dissemination of an informative leaflet regarding CHF and diuretic therapy developed for the purpose of this study. [excerpt]