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 identifie d by patients with congestive heart failure (CHF). Setting. University-associated heart failure clinic and a family practice c linic. Patients. Twenty-six patients with CHF. Intervention. Four focus group sessions. Measurements and Main Results. Participants were asked to describe how thei r 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, pa rticipants were asked for their opinions regarding various teaching and mem ory 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 li mitations 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 h ealth care providers; their own knowledge regarding the disease and drugs u sed to treat it; previous experience with drugs; support from family and fr iends: and ease of communication with health care professionals. Conclusion. Focus groups are an effective and efficient method to explore p atients' opinions of barriers to drug therapy adherence. Such information c an have a direct impact on management of patients with CHF. Information gat hered in this study will be used to construct a survey to measure barriers to drug adherence and design interventions to improve adherence.