Woman holding pills in her hand.

Project: Drug use in Coronary Heart Disease

The project investigates how healthcare can support patients with coronary heart disease in their use of medicines, so that patients feel well today and at the same time have good prevention for future coronary events. We use both quantitative and qualitative methods and the mainstay of the project is an intervention study.

Facts about the project

Project manager
Malin Johansson Östbring
Other project members
Lina Hellström, Göran Petersson, Linnaeus University, Tommy Eriksson, Malmö University, Jan Mårtensson, School of Health and Welfare, Jönköping University
Participating organizations
Linnaeus University, Region Kalmar County
Familjen Kamprads stiftelse 2013, FORSS 2014
Medicine (Department of Medicine and Optometry, Faculty of Health and Life Sciences)
eHealth Institute

More about the project

Patients with coronary heart disease, i.e. myocardial infarction or chronic angina, are treated to prevent further disease progress. Much of this secondary prevention is based on life style factors such as diet and exercise, but preventive drug treatment is also substantial. Patients’ who use several medicines a day often experience drug related problems, and they sometimes stop taking their medicines (are non-adherent), studies of patients in secondary prevention also show that treatment targets for risk factors such as blood pressure and cholesterol often are not met. When treating patients with preventive medicines it is of high importance to balance the future gains against the effects in the patient’s everyday life.

This research project investigates if health care can provide a support for patients which enable more individualization of drug treatment and better patient adherence. This is supposed to improve the prevention of disease, and would impact risk factor control and health care use.

An intervention has been developed which will be tested both on effect measures and process measures. The main feature of the intervention is that a clinical pharmacist with training in cardiology and motivational interviewing meet the patient at the cardiac clinic for a medication review about three months after discharge, and then offer continued support for about 6 months. A qualitative interview study that describe patients’ experiences with using medicines one year after their cardiac event is also a part of the research project.

The intervention study was conducted 2013-2018 and the results of effect measures will be published in 2020. The qualitative study found that patients’ experiences with using their medicines differed considerably. Some patients found handling the medicines and administering their treatment very easy, natural and straightforward while others found that it was distressing or troublesome, and influenced their lives extensively. There was a varied sense of personal responsibility about the treatment and use of medicines.

The findings of this study highlight a need for more individualized support for patients using medicines for secondary prevention. The patients often needed better dialogue with healthcare providers to optimally manage their medicines.

The project is part of the research at The e-Health Institute