A Description of Patient and Provider Experience and Clinical Outcomes After Heart Failure Shared Medical Appointment

Lisa B Cohen, Melanie Parent, Tracey H Taveira, Sandesh Dev, Wen-Chih Wu, Lisa B Cohen, Melanie Parent, Tracey H Taveira, Sandesh Dev, Wen-Chih Wu

Abstract

Background: Shared medical appointments (SMAs) are clinical visits in which several patients meet with 1 or more providers at the same time.

Objective: To describe the outcomes of an interdisciplinary SMA for veterans recently discharged for heart failure (HF).

Methods: A retrospective chart review for patients' readmission rates, survival, medication adherence, and medication-related problems. For qualitative outcomes, we performed semistructured interviews on 12 patients who had undergone HF SMAs and their respective caregivers focusing on care satisfaction, HF knowledge, disease self-care, medication reconciliation, and peer support.

Results: The cohort comprised 70 patients-49% had left ventricular function <40% and 50% were prescribed >10 medications. Medication-related problems occurred in 60% of patients. Interviews revealed overall satisfaction with HF-SMA, but patients felt overwhelmed with HF instructions, perceived lack of peer support and self-efficacy, and feelings of hopelessness related to HF.

Conclusion: Shared medical appointments are well-perceived. Medication problems and need for medication management are prevalent along with patient's lack of self-efficacy in HF care. Multiple HF-SMA visits may be needed to reinforce concepts, reduce confusion, and garner peer support.

Keywords: heart failure; interdisciplinary; medication adherence; patient care team; patient interviews; provider interviews; shared medical appointments.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Source: PubMed

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