Home healthcare professionals’ perspectives on quality dimensions for home pharmaceutical care in Japan

Abstract

Aim In Japan, home pharmaceutical care (HPC) has recently been provided to home‐bound older adults who have difficulties in accessing a community pharmacy, for regular medicine supplies and medication management. Although the number of HPC services provided has increased, HPC is not always carried out by clinically well‐trained pharmacists, causing differences in the quality of HPC provided. The aim of the present study was to establish the quality dimensions of HPC (i.e. components that impact the quality of HPC) from the perspectives of home healthcare professionals. Methods Semistructured interviews and focus groups were carried out with nine home healthcare teams, comprising 61 multidisciplinary professionals including pharmacists, doctors, nurses, care managers, home helpers, medical social workers and other relevant stakeholders involved in home healthcare. Participants’ responses were analyzed using thematic analysis. Identified themes were then categorized using Donabedian's framework (structure, process and outcome). Results Nine themes and 27 subthemes emerged, including: structure (pharmacist factors, pharmacy factors and external factors), process (before HPC, during HPC, after HPC and outside of HPC) and outcome (impact on patients and impact on other healthcare professionals). Conclusion This study has identified quality dimensions of HPC from multidisciplinary home healthcare professionals’ perspectives. These findings might be used to inform aspects of HPC that require improvement. In order to evaluate the quality of HPC, a set of indicators based on the identified quality dimensions could be developed. Geriatr Gerontol Int 2019; 19: 35–43.

Development and consensus testing of quality indicators for geriatric pharmacotherapy in primary care using a modified Delphi study

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The Role of Pharmacists in Home Health Care: A Study Set in a Regional Hospital in Taipei City

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Evaluation of changes in prescription among Japanese elderly patients before and after transition to home care

“…Although the use of HPC services has increased, HPC is not always provided by clinically well‐trained pharmacists, leading to differences in service quality. 30 In addition, the hierarchical relationship between physicians and pharmacists and the lack of understanding of each other's skills and knowledge pose a challenge to interprofessional collaboration. 31 Given the increasing role of pharmacists in home care, challenges associated with the HPC system and the relationship between physicians and pharmacists described above should be addressed to improve prescription quality in home care settings.…”