Using focus groups to identify barriers to drug use in patients with congestive heart failure.

STUDY OBJECTIVE

To explore barriers to adherence to drug therapy identified by patients with congestive heart failure (CHF).

SETTING

University-associated heart failure clinic and a family practice clinic.

PATIENTS

Twenty-six patients with CHF.

INTERVENTION

Four focus group sessions.

MEASUREMENTS AND MAIN RESULTS

Participants were asked to describe how their lives changed as a result of developing CHF and the challenges they face when taking drugs for the condition. In the second half of each session, participants were asked for their opinions regarding various teaching and memory aids for improving adherence with therapy. They recognized the value of these aids and often created their own when health care professionals did not supply them. Transcripts were reviewed and comments grouped to identify patient-perceived barriers to adherence. The disease placed significant limitations on lifestyle. Furosemide had dramatic effects on daily activities, and some patients altered the dosing schedule to accommodate their plans. Influences on adherence were generalized into five themes: confidence in health care providers; their own knowledge regarding the disease and drugs used to treat it; previous experience with drugs; support from family and friends; and ease of communication with health care professionals.

CONCLUSION

Focus groups are an effective and efficient method to explore patients opinions of barriers to drug therapy adherence. Such information can have a direct impact on management of patients with CHF. Information gathered in this study will be used to construct a survey to measure barriers to drug adherence and design interventions to improve adherence.