Briser les barrières à l'adhésion médicamenteuse : un programme d'éducation thérapeutique par le pharmacien clinicien permet-il d'améliorer l'adhésion médicamenteuse chez les patients ambulatoires atteints d'insuffisance cardiaque ? Étude prospective interventionnelle

Details

Supervisors

Dalleur, Olivia ; Duray, Clémence

Faculty

Faculté de pharmacie et des sciences biomédicales

Degree label

Master de spécialisation en pharmacie hospitalière

Abstract

Background: Medication non-adherence in patients with heart failure (HF) is associated with increased readmissions, mortality risk, and hospitalizations. The non-adherence rate is substantial among these patients. Patient therapeutic education (PTE) is a strategy proposed to address non-adherence. Objectives: The primary objective is to evaluate the impact of a new PTE program led by pharmacists on medication adherence in patients with HF. The program's impact on the number of adherence barriers, quality of life, and patient satisfaction will also be assessed. Methods: A new PTE program was developed based on behavior change theories and recommendations from the French National Authority for Health (HAS). The impact of this program was evaluated through a pilot before/after study. Medication adherence, the number of adherence barriers, and the quality of life of HF patients were assessed immediately before the PTE session and 30 days after. Patient satisfaction was also measured 30 days post-session. Medication adherence was evaluated using the Mascard scale, adherence barriers using the Adherence Starts with Knowledge-12 questionnaire, and quality of life using the Minnesota Living with Heart Failure Questionnaire. Results: The PTE session significantly improved adherence, as indicated by the ASK-12 score, in patients who were initially unaware of their medications' roles (P = 0.042). In the overall population, the Mascard score slightly increased, and the number of barriers decreased, although these differences were not significant. However, a significant decrease in patients' quality of life was observed after the session. All patients reported being satisfied or very satisfied with the PTE session. Conclusion: This pilot study demonstrated the effectiveness of a new PTE program in improving medication adherence among patients who were initially poorly informed about their treatments. These results support the continuation of this PTE to optimize medication adherence, thereby providing a promising strategy to achieve therapeutic goals in heart failure patients with suboptimal outcomes.