Medicines-related hospital admissions and medication reviews: patients' and pharmacists' perspectives

Research output: ThesisDoctoral Thesis

Abstract

Medicines-related hospital admissions are responsible for 3.7% - 7.7% of all hospital admissions. Discharge from hospital is a particularly challenging time regarding medicines management. When patients transfer from one setting to another, 52.7% experience at least one medicine-related problem. Post-discharge medication review by community pharmacists has been postulated as a way of minimising medicines-related problems after hospital discharge with the aim of reducing medicines-related hospital readmissions.

The aims of this study were to explore the knowledge and attitudes of patients and community pharmacists around post-discharge medicines support and to determine how pharmacists could help patients manage their medicines better once discharged from hospital.

A preliminary phase of the study used Hospital Episode Statistics data to establish the trends in medicines-related hospital admissions from 2008 to 2015. Following this a mixed-methods sequential exploratory design was used. Qualitative data were generated from interviews with seven patients who had a medicines-related hospital admission and five community pharmacists providing the medicines-use review service. Quantitative data were produced from a survey of 495 community pharmacists in England.

The study found that community pharmacists have the expertise, are willing and well positioned to support patients managing their medicines after a hospital discharge. Barriers persist around their ability to build key relationships, effective methods of communication and integration into the primary healthcare team. Further work is required to ensure that patients and healthcare professionals are aware of community pharmacists’ expertise and how embedding their role, and that of GP practice pharmacists, in discharge pathways would benefit patient care.

In conclusion, new ways of working and enhanced use of IT are required to facilitate and optimise patient care during transitions from hospital to primary care. Community pharmacists are well placed to support patients after hospital discharge but should be better integrated into the primary-care team.
Original languageEnglish
Awarding Institution
  • University of Bath
Supervisors/Advisors
  • James, Lynette, Supervisor, External person
  • Weiss, Marjorie, Supervisor, External person
  • Taylor, Andrea, Supervisor, External person
  • Rogers, Philip, Supervisor, External person
Award date11 Jul 2019
Publication statusPublished - 26 Mar 2019

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