Gordon, Karen; (2002) Drug-related problems in cardiovascular patients in primary care. Doctoral thesis (Ph.D.), University College London.

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Abstract

Coronary Heart Disease and stroke are key priorities for the NHS because they cause morbidity and mortality. Cardiovascular patients take multiple medicines for cardiovascular diseases and co-existing diseases and frequently use health services, and therefore encounter drug-related problems (DRPs). The aim of this research is to identify and characterise medicine-related and service-related problems experienced by cardiovascular patients using a screening tool in GP surgeries and community pharmacies. A screening interview (tool) was developed to identify DRPs and was administered to 259 cardiovascular patients recruited from 5 GP surgeries and 4 community pharmacies in London. Of the 259 participants, 98 consented to a home interview, which validated the DRPs identified using the screening tool and provided more in-depth information and patients' views on their use of medicines and services. Additionally, their records in participating GP surgeries and pharmacies were reviewed providing additional information on their responses. Of the 98 participants, 53 (54%) were assigned to the study group (participants with DRPs) following the screening interviews, compared with 64 (65%) finally being assigned to the study group following home interviews. The number of DRPs doubled from the screening interviews to the home interviews because of the in-depth nature of the home interview; however, the screening tool may be used to identify patients at risk of DRPs. The screening tool should be used routinely in GP surgeries and pharmacies in conjunction with medication review clinics to assess the medicines and services used by patients. DRPs, such as non-compliance, lack of information, problems impinging on the ability of a patient to consult a GP, may be addressed. Patients should be encouraged to voice their opinions and concerns about their medicines and services. This research study supports the involvement of other HCPs, e.g. pharmacists, in reviewing and optimising patients' treatment with medicines.

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