Evaluation of a pharmacist-led shared decision-making in atrial fibrillation and patients’ satisfaction—a before and after pilot study

• DOI: 10.1007/s11845-020-02343-y
• Publication Date: 2020-08-17T20:03:53Z
• Authors: Viviane Khalil; Samantha Blackley; Ashwin Subramaniam
• Keywords: Male; Pilot Projects; Pharmacists; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Patient Satisfaction; Atrial Fibrillation; Chronic Disease; Humans; Female; Prospective Studies; Decision Making, Shared; Aged

Chronic complex diseases like atrial fibrillation have potential long-term economical and personal consequences. Shared decision-making principles may promote therapeutic compliance, satisfaction and outcomes. Pharmacists, as patient-advocates, play a key role in guiding them through complex clinical decisions about their chronic disease management and anticoagulation choices.To evaluate the impact of pharmacist-led shared decision making on patients' satisfaction and appropriateness of their anticoagulation therapy in newly diagnosed atrial fibrillation patients.A prospective 2-phase before and after single-centre study was conducted in an Australian hospital. Phase 1 provided usual care, and patients' satisfaction and appropriateness of their anticoagulation therapy were evaluated. Phase-2 assessed the impact on satisfaction and appropriateness of anticoagulant therapy following pharmacist-led interventions of shared decision making to promote patients' involvement.Patients with pharmacist-led shared decision making reported higher degree of appropriateness of anticoagulation therapy and satisfaction (36% vs 92%, P < 0.001; 25% vs 68, P < 0.001), respectively. Additionally, patients who had a pharmacist input during their hospital stay received guideline-recommended anticoagulant therapy and reported satisfaction with their management was also higher in stage 2 (21% vs 65%, p < 0.001).The study highlights pharmacist-led shared decision making in atrial fibrillation that contributes to patient satisfaction and appropriateness of therapy.