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

Cohen LB, Parent M, Taveira TH, Dev S, Wu WC. A Description of Patient and Provider Experience and Clinical Outcomes After Heart Failure Shared Medical Appointment. Journal of patient experience. 2017 Dec 1; 4(4):169-176.

Related HSR&D Project(s)

• IIR 14-293 – Group Medical Visits in Heart Failure for Post-Hospitalization Follow-Up

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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.