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

• Published in: Journal of patient experience Vol. 4; no. 4; pp. 169 - 176
• Main Authors: Cohen, Lisa B, Parent, Melanie, Taveira, Tracey H, Dev, Sandesh, Wu, Wen-Chih
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.12.2017; Sage Publications Ltd; SAGE Publishing
• Subjects: Heart failure; Patient compliance; Patients; Peer tutoring; patient care team; heart failure; shared medical appointments; provider interviews; patient interviews; medication adherence; interdisciplinary
• ISSN: 2374-3735; 2374-3743; 2374-3743; 2374-3735
• DOI: 10.1177/2374373517714452

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.