Impact of an integrated medicines management service on preventable medicines-related readmission to hospital: a descriptive study

Barnett, Nina; Dave, Krupa; Athwal, Devinder; Parmar, Paresh; Kaher, Sunaina; Ward, Christine

doi:10.1136/ejhpharm-2016-000984

Cited by 7 publications

(26 citation statements)

References 22 publications

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“…Patients described experiencing medication discrepancies including wrong frequency, incorrect time, dosage or missed prescription regime following discharge from hospital because of poor communication and lack of clear and adequate information about their medications 68,70 . In some quantitative studies, interventions that focused on communication with patients, primary care physicians (PCPs) and community pharmacists after patients' discharge improved the discharge experience and enabled patients to manage their medications properly at home, leading to reduced medication-related hospitalisation rates 56,78 . and clearly written instructions of their current treatment plan and provision of discharge summaries.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies addressed the theme of communication strategies to enable older patients' medication knowledge 53,54,56,60,63,67,71,72,74,76,80,82,85 . There were three subthemes for this theme: individualised discharge summaries, pharmacists' interventions and improvements in older patients' medication knowledge through medication education.…”

Section: Theme 4 Communication Strategies To Enable Older Patients' mentioning

confidence: 99%

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A systematic review of older patients’ experiences and perceptions of communication about managing medication across transitions of care

Ozavci

Bucknall

Woodward‐Kron

et al. 2021

Research in Social and Administrative Pharmacy

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Background Communication about managing medications may be difficult when older people move across transitions of care. Communication breakdowns may result in medication discrepancies or incidents. Objective The aim of this systematic review was to explore older patients' experiences and perceptions of communication about managing medications across transitions of care. Design A systematic review Methods A comprehensive review was conducted of qualitative, quantitative and mixed method studies using CINAHL Complete, MEDLINE, Embase and PsycINFO, Web of Science, INFORMIT and Scopus. These databases were searched from inception to 14.12.2018. Key article crosschecking and hand searching of reference lists of included papers were also undertaken. Inclusion criteria: studies of the medication management perspectives of people aged 65 or older who transferred between care settings. These settings comprised patients' homes, residential aged care and acute and subacute care. Only English language studies were included. Comments, case reports, systematic reviews, letters, editorials were excluded. Thematic analysis was undertaken by synthesising qualitative data, whereas quantitative data were summarised descriptively. Methodological quality was assessed with the Mixed Methods Appraisal Tool. Results The final review comprised 33 studies: 12 qualitative, 17 quantitative and 4 mixed methods studies. Twenty studies addressed the link between communication and medication discrepancies; ten studies identified facilitators of self-care through older patient engagement; 18 studies included older patients' experiences with health professionals about their medication regimen; and, 13 studies included strategies for communication about medications with older patients. Poor communication between primary and secondary care settings was reported as a 2 reason for medication discrepancy before discharge. Older patients expected ongoing and tailored communication with providers and timely, accurate and written information about their medications before discharge or available for the post-discharge period. Conclusions Communication about medications was often found to be ineffective. Most emphasis was placed on older patients' perspectives at discharge and in the post-discharge period. There was little exploration of older patients' views of communication about medication management on admission, during hospitalisation, or transfer between settings.

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Section: Resultsmentioning

confidence: 99%

Section: Theme 4 Communication Strategies To Enable Older Patients' mentioning

confidence: 99%

A systematic review of older patients’ experiences and perceptions of communication about managing medication across transitions of care

Ozavci

Bucknall

Woodward‐Kron

et al. 2021

Research in Social and Administrative Pharmacy

View full text Add to dashboard Cite

show abstract

“…This program of work is currently being evaluated but preliminary data suggests that a combination of support is desirable, including formal training, group workshops and one-to-one practice based visits [ 39 , 40 ]. The coaching approach was central to the development of an integrated medicines management service [ 41 ] and health coaching training has now been commissioned for healthcare professionals working in the Northwest London area [ 39 ].…”

Section: Using Health Coaching To Support Adherence Through Personmentioning

confidence: 99%

Using Theory to Explore the Determinants of Medication Adherence; Moving Away from a One-Size-Fits-All Approach

Easthall

Barnett

2017

Pharmacy

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Non-adherence to prescribed medicines has been described as “a worldwide problem of striking magnitude”, diminishing treatment effects and wasting resources. Evidence syntheses report current adherence interventions achieve modest improvements at best, and highlight the poor progress toward the longstanding aim of a gold-standard intervention, tailored to meet individual need. Techniques such as motivational interviewing and health coaching, which aim to facilitate patient-centred care and improve patient resourcefulness, have shown promise in supporting adherence, especially in patients with psychological barriers to medicine-taking, such as illness perceptions and health beliefs. Despite a plethora of research, there is little recognition that the nature and complexity of non-adherence is such that a one-size-fits-all approach to interventions is never likely to suffice. This commentary re-visits the call for adherence interventions to be tailored to meet individual need, by considering what this means for day-to-day practice and how this can be achieved. It provides an update on advances in psychological theory to identify the root cause of an individual’s non-adherence to encourage matching of provided adherence support. It also provides a practical perspective by considering exemplars of innovative practice and evaluating the day-to-day practicalities of taking a novel approach.

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“…Some studies have even evidenced the causality associated, highlighting warfarin as a “definitely” responsible for GI bleeds . However, it has been shown that services like the integrated medicines management is effective in reducing the risk of hospital re‐admissions, a service where pharmacists play a key role …”

Section: Resultsmentioning

confidence: 99%

“…80 However, it has been shown that services like the integrated medicines management is effective in reducing the risk of hospital readmissions, a service where pharmacists play a key role. 81,82 Five to twenty percent of hospital admissions are caused by medication misuse and more than half of these are avoidable. Medication nonadherence is one of the areas for concern, as it is estimated that 11% to 22% of hospital admissions for exacerbations of chronic disease are a direct result of it.…”

Section: Secondary Care For Episodes Of Ill Healthmentioning

confidence: 99%

The patient pathway in cardiovascular care: A position paper from the International Pharmacists for Anticoagulation Care Taskforce (iPACT)

Costa

Rydant²,

Antoniou

2020

Evaluation Clinical Practice

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Background This position paper highlights the opportunistic integral role of the pharmacist across the patient pathway utilizing cardiovascular care as an example. The paper aims to highlight the potential roles that pharmacists worldwide can have (or already have) to provide efficient patient care in the context of interprofessional collaboration. Methods It results from a literature review and experts seeking advice to identify existing interventions and potential innovative interventions. We developed a conceptual framework highlighting seven critical phases in the patient pathway and for each of those listed some of the initiatives identified by our experts worldwide. Results Existing pharmacists' interventions in each of these phases have been identified globally. Various examples in the area of prevention and self‐management were found to exist for long; the contribution for early detection and subsequently to timely diagnosis were also quite clear; integration of care was perhaps one of the areas needing greater development, although interventions in secondary care were also quite common. Tertiary care and end of life interventions were found to often be left for other healthcare professionals. Conclusion On the basis of the findings, we can argue that much has been done but globally consider that pharmacists are still an untapped resource potentially useful for improved patient care.

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Impact of an integrated medicines management service on preventable medicines-related readmission to hospital: a descriptive study

Cited by 7 publications

References 22 publications

A systematic review of older patients’ experiences and perceptions of communication about managing medication across transitions of care

A systematic review of older patients’ experiences and perceptions of communication about managing medication across transitions of care

Using Theory to Explore the Determinants of Medication Adherence; Moving Away from a One-Size-Fits-All Approach

The patient pathway in cardiovascular care: A position paper from the International Pharmacists for Anticoagulation Care Taskforce (iPACT)

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