Focal points
□ The study determined the extent of post‐operative interventions required for patients admitted for elective hip or knee arthroplasty
□ In Phase 1, patients were pre‐assessed by nurses at admission, according to existing practice; in Phase 2, patients received pharmacist‐led pre‐assessment
□ There were 131 interventions (2.05 per patient) in Phase 1 compared with 40 (0.68 per patient) in Phase 2, a reduction of approximately 70 per cent
□ This study demonstrates that pharmaceutical pre‐assessment substantially reduces the number of interventions made during patients' post‐operative stay.
ObjectivesTo investigate the perception and experience of patients and the public (PP) about community pharmacy (CP) services and other primary care services after hospital discharge back home.Design and settingA rapid review and qualitative study exploring PP perceptions of primary care, focusing on CP services in the UK.MethodsA mixed-methods approach was adopted including a rapid review undertaken between 24 April and 8 May 2019 across four databases (MEDLINE, EMBASE, PsycINFO and CINAHL). Semistructured interviews were then conducted investigating for shifts in current PP perception, but also nuanced opinion pertaining to CP services. A convenience sampling technique was used through two online PP groups for recruitment. Thematic framework analysis was applied to interview transcripts.ParticipantsAny consenting adults ≥18 years old were invited regardless of their medical condition, and whether they had used post-discharge services or not.ResultsTwenty-five studies met the inclusion criteria. Patients were generally supportive and satisfied with primary care services. However, some barriers to the use of these services included: resource limitations; poor communication between healthcare providers or between patient and healthcare providers; and patients’ lack of awareness of available services. From the 11 interviewees, there was a lack of awareness of CP post-discharge services. Nevertheless, there was general appreciation of the benefit of CP services to patients, professionals and wider healthcare system. Potential barriers to uptake and use included: accessibility, resource availability, lack of awareness, and privacy and confidentiality issues related to information-sharing. Several participants felt the uptake of such services should be improved.ConclusionThere was alignment between the review and qualitative study about high patient acceptance, appreciation and satisfaction with primary care services post-discharge. Barriers to the use of CP post-discharge services identified from interviews resonated with the existing literature; this is despite developments in pharmacy practice in recent times towards clinical and public health services.
Focal points
The National Service Framework for Older People calls for regular medication review for all patients over the age of 75
Studies have shown that pharmacists take more accurate admission medication histories than do junior medical staff, but few studies have evaluated pharmacist‐mediated medication review
An ethnographic study was used to develop structured protocols for medication review and history taking, which were evaluated by a pharmacist on two acute medical wards
The study found that a structured medication review by a pharmacist results in more appropriate prescribing, including discontinuing drugs no longer required or contraindicated, avoiding adverse drug reactions and tailoring therapy to patient's needs
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