Preventing medication errors in patients with decompensated heart failure and cognitive impairment following hospital discharge, in Saudi Arabia

Abstract

Abstract Background Heart failure (HF) is a progressive health challenge, with an increased prevalence of 30% in older adults. It is estimated that approximately 50% of patients with HF have a degree of cognitive impairment, affecting adherence to self-care and medication taking. Therefore, medication errors are becoming a global health challenge and account was estimated at 44.4% in Saudi Arabia. Purpose To explore the perspectives of patients with cognitive impairment and their caregivers on the pre-discharge medication education received. Methods A qualitative study, using semi-structured interviews. 7 dyads were recruited from a Cardiac center in Saudi Arabia The purposive sample was selected of patients who are identified as having cognitive impairment, as assessed by Montreal Cognitive Assessment scale (MoCA). Caregivers were nominated by the respective patient. Interviews were audio recorded, transcribed in Arabic, and translated into English. Transcripts were checked for authenticity. Data were analysis using thematic analysis. Results Most patients identified as male (n=5), including both patients with mild cognitive impairment (n=4) and moderate cognitive impairment (n=3). Four major themes were identified Complexity of Medication Management: Patients and caregivers struggle with the multifaceted nature of medication regimens, indicating a need for simplified schedules and clear instructions. Importance of Clear Communication and Education: There’s a critical need for comprehensive, understandable information about the indications and side effects of the medications. This should be tailored to individual learning preferences. Crucial Role of Caregiver Support: Caregivers have an important role in ensuring medication adherence. Some highlighted the benefit of being included in educational interventions. Challenges with Post-Discharge Support: All participants expressed a sense of abandonment post-discharge, with difficulties in accessing follow-up. Conclusion The study highlights the need for simplified medication regimens, enhanced communication, and comprehensive education for heart failure patients with cognitive impairment and their caregivers. Addressing these interconnected challenges through a multifaceted approach is crucial for improving medication management, adherence, and overall patient outcomes.