Medication reviews in hospitalized patients: a qualitative study on perceptions of primary and secondary care providers on interprofessional collaboration

BMC Health Services Research

Godelieve Ponjee¹  Fatma Karapinar Çarkit²  Bregje Walraven³  Wieke Heideman⁴ 

[1] Department of Clinical Pharmacy, Amsterdam UMC location AMC, Amsterdam, the Netherlands;Department of Clinical Pharmacy, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands;Department of Clinical Pharmacy, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands;Present address: Department of Psychiatry, GGZ in Geest, Haarlem, the Netherlands;Department of Research and Epidemiology, OLVG, Amsterdam, Netherlands;

关键词: Medication review;    Medication therapy management;    Polypharmacy;    Interprofessional relations;    Continuity of care;   

DOI  :  10.1186/s12913-020-05744-y

来源: Springer

【 摘 要 】

BackgroundIn-hospital medication reviews are regularly performed. However, discontinuity in care could occur because secondary care providers lack insight into the outpatient history. Furthermore, for the implementation or follow-up of some medication review-based interventions, the help of primary care providers is essential. This requires interprofessional collaboration between secondary and primary care. Therefore, the aim of this qualitative study was to gain insight into the perceptions of primary and secondary care providers on interprofessional collaboration on medication reviews in hospitalised patients.MethodsTen face-to-face semi-structured interviews and three focus group discussions were conducted with 20 healthcare providers from three hospitals and community health services. The interviews were aimed at exploring general practitioners’, community pharmacists’, geriatricians’, and hospital pharmacists’ experiences, attitudes, and views of interprofessional collaboration. Focus groups consisted of representatives of all professional groups. Through group discussion, interprofessional collaboration was explored by addressing three main questions: 1) What are the benefits of in-hospital medication reviews? 2) What are the barriers to in-hospital medication reviews from an interprofessional collaboration perspective? 3) Given the barriers mentioned, how should this interprofessional collaboration between primary and secondary care be designed? Data were analysed using a thematic-content approach.ResultsThe need for in-hospital medication reviews was underlined due to their many benefits, such as reducing potentially preventable re-admissions. Barriers regarding interprofessional collaboration between primary and secondary care can be subdivided into three main themes: 1) defining in-hospital medication reviews (e.g., lack of clear goals), 2) execution of medication reviews (e.g., hospital setting is dynamic), and 3) follow-up after discharge (e.g., unclear instructions). Care providers suggested solutions for each of the barriers mentioned, for example, by using supportive staff in order to overcome the gap between primary and secondary care providers and making clear agreements on proper means of communication.ConclusionPrimary and secondary care providers recognise the importance of in-hospital medication reviews and the need for interprofessional collaboration. To create satisfying interprofessional collaboration, conditions should be met on defining in-hospital medication reviews across settings and involving both primary and secondary care providers in implementing medication reviews and organising their follow-up.

【 授权许可】

CC BY