COVID-19 Patients’ Medication Management during Transition of Care from Hospital to Virtual Care: A Cross-Sectional Survey and Audit

Hattingh, H. Laetitia; Edmunds, Catherine; Buksh, Saberina; Cronin, Sean; Gillespie, Brigid M.

doi:10.3390/pharmacy11050157

Cited by 3 publications

(1 citation statement)

References 53 publications

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“…The consolidated criteria for reporting qualitative research (COREQ) checklist [ 27 ] and qualitative research criteria were used during the development, analysis, and reporting of the interviews [ 28 , 29 ]. This study was part of a mixed-methods research project that incorporated patient surveys and a retrospective audit of medical records, reported elsewhere [ 30 ]. The project was approved by the Gold Coast Hospital and Health Service (GCHHS) Human Research Ethics Committee (LNR/2022/QGC/83951).…”

Section: Methodsmentioning

confidence: 99%

Medication management of COVID-19 patients during transition to virtual models of care: a qualitative study

Hattingh,

Edmunds,

Gillespie

2023

J of Pharm Policy and Pract

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Introduction Expansion of hospital service models was one of the strategies implemented to manage the COVID-19 pandemic through virtual models of care. COVID-19 patients were hospital inpatients transferred to virtual wards and managed outside the hospital. Pharmacists had to provide distance medication management and support services. Virtual care patient support incorporated telehealth consultations by doctors, pharmacists and nurses. This study explored hospital clinicians’ experiences and perspectives on medication management and safety issues of the COVID-19 patients transferred from inpatient units (IPUs) to virtual models of care at the time of transfer. Methods Semi-structured qualitative interviews were conducted with purposively selected doctors, pharmacists and nurses involved in the management of COVID-19 patients in a virtual model of care (home or hotel). Clinicians were interviewed face-to-face or via MS Teams between March and May 2022. An interview schedule included 13 questions and prompts to explore perceptions of medication management and safety aspects. Results Twenty clinicians were interviewed: six doctors, seven pharmacists, and seven nurses. The average interview time was 26 min (SD: 4.7; range 21–39). Four major medication management and safety themes emerged from the data: (1) complexities involved in efficient handover between IPU and virtual models of care; (2) lack of clarity on roles and responsibilities between hospital and primary care clinicians; (3) communication challenges when pharmacists work remotely; and (4) proactive management of specific medication safety risks. A common thread throughout the themes was concerns for potential impact on patient safety. Conclusion Overall, clinicians were supportive of the virtual models although patient safety issues were raised that need to be addressed in the development of future services. The results from this study may inform improvements in medication safety implementation of future virtual models of care.

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Section: Methodsmentioning

confidence: 99%

Medication management of COVID-19 patients during transition to virtual models of care: a qualitative study

Hattingh,

Edmunds,

Gillespie

2023

J of Pharm Policy and Pract

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Recent temporal trends, characteristics and outcomes of patients with non‐COVID‐19 community‐acquired pneumonia at two tertiary hospitals in Australia: an observational study

Sharma,

Mangoni,

Shahi

et al. 2024

Internal Medicine Journal

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BackgroundCommunity‐acquired pneumonia (CAP) leads to considerable morbidity and mortality globally. However, data on CAP burden in Australia, especially during the coronavirus disease 2019 (COVID‐19) pandemic, are limited.AimsWe characterised and assessed clinical outcomes of non‐COVID‐19 CAP hospitalisations over a 6‐year period at two major hospitals in South Australia.MethodsAll non‐COVID‐19 CAP hospitalisations were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian modification (ICD‐10‐AM) codes, between 1 January 2018 and 31 December 2023, at two tertiary hospitals in Adelaide. Clinical outcomes included in‐hospital and 30‐day mortality, length of stay (LOS) in, intensive care unit (ICU) admission and 30‐day readmissions. Multilevel regression models were utilised to identify predictors of clinical outcomes.ResultsOver the 6‐year period, there were 7853 non‐COVID‐19 CAP hospitalisations, with a temporal increase from 100 per 100 000 population in 2018 to 208 per 100 000 population in 2023 (P < 0.001). The mean (SD) age was 75.1 (17.6) years, and 54.6% were males. The mean age declined over time (P < 0.05), while other characteristics remained stable. Streptococcus pneumoniae was the most commonly identified bacterium (21.8% of cases). In‐hospital mortality occurred in 7.8% of patients, with 30‐day mortality and readmission rates of 14.3% and 16.9% respectively. LOS declined significantly during the pandemic years; however, mortality remained stable over time. Frailty status, malnutrition and number of comorbidities significantly predicted 30‐day mortality and LOS, in addition to pneumonia severity and ICU admission.ConclusionsThere has been an increasing trend of hospitalisations for non‐COVID‐19 CAP during the COVID‐19 pandemic, with a concomitant trend towards shorter LOS and no significant shift in other clinical outcomes.

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Enhancing the quality of medicine handover at hospital discharge: a priority setting workshop

Hattingh,

Johnston,

Percival

et al. 2024

HIM J

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Background: When a patient is discharged from hospital it is essential that their general practitioner (GPs) and community pharmacist are informed of changes to their medicines. This necessitates effective communication and information-sharing between hospitals and primary care clinicians. Objective: To identify priority medicine handover issues and solutions to inform the co-design and development of a multifaceted intervention. Method: A modified nominal group technique was used to reach consensus on medicine handover priority areas. The first hour of an interactive 2-hr workshop focused on ranking pre-identified issues drawn from literature. In the second hour, participants identified solutions that they then ranked from highest to lowest priority through an online platform. Descriptive statistics were used to analyse workshop data. Results: In total 32 participants attended the workshop including hospital doctors ( n = 8, 25.0%), GPs and hospital pharmacists ( n = 6 each, 18.8%), consumers and community pharmacists ( n = 4 each, 12.5%), and both hospital and aged care facility nurses ( n = 2 each 6.3%). From the list of 23 issues, the highest ranked issue was high workload and time pressures impacting the discharge process (22/32). From the list of 36 solutions, the participants identified two solutions that were equally ranked highest (12/27 each). They were mandating that patients leave hospital with a discharge summary, including medication reconciliation information and, developing an integrated information technology system where medication summary and notes are accessible for primary, secondary and tertiary health provider. Conclusion: The consensus process highlighted challenges in hospital procedures where potential solutions may be implemented through co-design of a multifaceted intervention to improve medicine handover quality.

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COVID-19 Patients’ Medication Management during Transition of Care from Hospital to Virtual Care: A Cross-Sectional Survey and Audit

Cited by 3 publications

References 53 publications

Medication management of COVID-19 patients during transition to virtual models of care: a qualitative study

Medication management of COVID-19 patients during transition to virtual models of care: a qualitative study

Recent temporal trends, characteristics and outcomes of patients with non‐COVID‐19 community‐acquired pneumonia at two tertiary hospitals in Australia: an observational study

Enhancing the quality of medicine handover at hospital discharge: a priority setting workshop

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